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medical coding and billing specialist resume example with 2+ years of experience

Jessica Claire
, , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - resumesample@example.com - : - -
Summary

Well-organized medical biller, coder and collections specialist with 4 years of experience in working with various insurance companies, billing clean claims daily and managing patient accounts per daily. Efficient at analyzing and validating patient information, diagnoses and billing data. Skilled in drafting invoices and resolving billing disputes quickly. Proficient in Office Practicum and Instamed.

Skills
  • Patient data identification
  • Knowledgeable in [Software]
  • Healthcare claim coding
  • Medical record security
  • Data entry
  • Medical terminology
  • Insurance billing
  • Insurance Verification
  • Billing procedures
  • Database management
  • Medical recordkeeping
  • Leadership
  • Computer skills
  • Decision-making
  • Conflict resolution
  • Working collaboratively
  • Reliable and trustworthy
Experience
08/2020 to Current
Medical Coding and Billing Specialist Pacific Dental Services Tualatin, OR,
  • Notified customers of delinquent accounts with attempt to collect outstanding amounts.
  • Processed payments over phone and set up recurring drafts.
  • Received payment and posted to appropriate customer accounts.
  • Remained calm, stayed professional and provided exceptional service on calls, even when interacting with difficult individuals.
  • Arranged for debt repayment and established repayment schedule based on customer finances.
  • Recorded and updated customer personal accounts with accurate contact information.
  • Maintained strict confidentiality with adherence to HIPAA guidelines and regulations.
  • Reviewed accounts to determine payment plan compliance.
  • Recorded information about customers' financial status and collections status efforts.
  • Located and monitored overdue accounts using billing system to begin collections process.
  • Negotiated credit extensions to assist customers in paying overdue accounts.
  • Investigated rejected and denied claims, correcting applicable coding.
  • Submitted clean claims to insurance companies electronically to secure payments.
  • Translated patient information into alphanumeric and numeric medical codes
  • Maintained confidentiality on all patient record data.
  • Conveyed current account information and obtained payments by using pre-scripted statements.
  • Utilized Level 1 HCPCS and Level 2 HCPCS systems to complete coding tasks.
  • Negotiated rates with customers and entered payments into accounting system.
  • Obtained prompt payments for open bills by interacting with appropriate parties.
  • Verified insurance eligibility for patients by calling appropriate parties.
  • Coded invoices properly based upon patient services and medical records.
  • Worked with [Software] to create and submit large numbers of client invoices each day.
  • Identified impact of proposed solutions for delinquent clients, discussed options and determined candidates for foreclosure.
  • Maintained consistent high performance by establishing solid record of achieving or exceeding objectives through use of [Technique] and [Skill].
  • Prepared packages containing all pertinent documentation for collections accounts.
  • Sent meticulous and accurate bills to collect payment from customers according to company protocol.
  • Negotiated customer rates and processed payments using [Software].
  • Drafted reports, contacted customers and reconciled transactions after conducting research into inquiries.
  • Tallied transactions, verified pricing and rectified errors in system.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
  • Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
  • Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
  • Communicated with healthcare personnel, including practitioners to promote accuracy.
  • Used computer system to record weekly expenditures and balances.
  • Submitted and accurately processed insurance claims with related medical code verifications and assessments.
  • Maintained high accuracy rate on daily production of completed reviews.
  • Categorized health services and assigned specific [Type] code to each one.
  • Recorded, stored and reported medical coding information to create statistics of healthcare encounters.
  • Coded outpatient encounters at rate of [Number] per day and [Number] complex specialty coding, maintaining [Number]% accuracy.
  • Received, organized and maintained all coding and reimbursement periodicals and updates.
  • Reviewed medical record information to identify all appropriate coding based on [Type] and [Type] categories.
  • Acted as liaison between business department, billers and third party payers in resolving billing and reimbursement accuracy.
  • Thoroughly reviewed remittance codes from EOBS/AR's.
  • Verified final claim submissions by comparing account charges with documentation.
  • Sought clarification from physicians and other hospital personnel for answers to needed coding interpretations prior to abstracting records.
  • Verified and abstracted all medical data to assign appropriate codes for hospital inpatient records.
  • Reviewed and abstracted relevant clinical data from electronic medical records to select appropriate code for procedures.
  • Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Coded medical observations and professional services delivered for each patient.
  • Carefully coded disease and injury diagnoses, acuity of care and procedures in inpatient setting.
  • Quickly responded to staff and client inquiries regarding CPT codes.
  • Verified proper coding, sequencing of diagnoses and accuracy of [Type] procedures.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
  • Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
  • Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
  • Assigned procedure and diagnosis codes for insurance billing using [Software].
  • Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
06/2019 to 08/2020
Medical Coding and Billing Specialist Pacific Dental Services Upland, CA,
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
  • Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
  • Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
  • Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
  • Communicated with healthcare personnel, including practitioners to promote accuracy.
  • Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
  • Assigned procedure and diagnosis codes for insurance billing using [Software].
  • Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
  • Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
  • Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
  • Verified proper coding, sequencing of diagnoses and accuracy of [Type] procedures.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Quickly responded to staff and client inquiries regarding CPT codes.
  • Carefully coded disease and injury diagnoses, acuity of care and procedures in inpatient setting.
  • Coded medical observations and professional services delivered for each patient.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
  • Reviewed and abstracted relevant clinical data from electronic medical records to select appropriate code for procedures.
  • Sought clarification from physicians and other hospital personnel for answers to needed coding interpretations prior to abstracting records.
  • Verified and abstracted all medical data to assign appropriate codes for hospital inpatient records.
  • Verified final claim submissions by comparing account charges with documentation.
  • Thoroughly reviewed remittance codes from EOBS/AR's.
  • Acted as liaison between business department, billers and third party payers in resolving billing and reimbursement accuracy.
  • Recorded, stored and reported medical coding information to create statistics of healthcare encounters.
  • Coded outpatient encounters at rate of [Number] per day and [Number] complex specialty coding, maintaining [Number]% accuracy.
  • Received, organized and maintained all coding and reimbursement periodicals and updates.
  • Reviewed medical record information to identify all appropriate coding based on [Type] and [Type] categories.
  • Categorized health services and assigned specific [Type] code to each one.
  • Maintained high accuracy rate on daily production of completed reviews.
  • Submitted and accurately processed insurance claims with related medical code verifications and assessments.
  • Used computer system to record weekly expenditures and balances.
01/2019 to 06/2019
Front Desk Receptionist Brown & Brown, Inc. San Diego, CA,
  • Handled payment processing and provided customers with receipts and proper bills and change.
  • Welcomed patrons to front desk and engaged in friendly conversations while conducting check-in process.
  • Received incoming calls and coordinated with hotel staff to fulfill requests and resolve issues.
  • Responded to inquiries and room requests made online, by phone or email.
  • Signed for packages, recorded deliveries and distributed to personnel.
  • Collaborated with housekeeping and maintenance staff to address and mitigate facility issues.
  • Input customer data into reservation software and made immediate updates to reflect room changes.
  • Checked and secured building areas during off-hours to prevent entry by unauthorized individuals.
  • Scheduled and confirmed appointments.
  • Answered and directed incoming calls using multi-line telephone system.
  • Answered phone calls, provided information to callers and connected callers to appropriate people.
  • Answered office phone and emails to schedule appointments, forward information and complete [Task].
  • Greeted incoming patients and verified paperwork to manage smooth intake processes.
  • Delivered administrative support to team members by making copies, sending faxes, organizing documents and rearranging schedules.
  • Maintained daily calendars, set appointments with clients and planned daily office events.
  • Processed payments and updated accounts to reflect balance changes.
  • Pulled and organized requested documentation.
  • Greeted visitors and directed them to appropriate areas, verifying reasons for visit and [Type] information.
  • Sorted incoming mail and directed to correct personnel each day.
  • Screened and verified visitors for identification credentials and purpose of visit to maintain security of personnel and office environment.
  • Confirmed transactional data by verifying name and payment information and clearly communicating costs and fees to patrons.
  • Communicated with outside offices to obtain records and transfer files for [Type] needs.
  • Determined needs of visitors and provided information or solutions.
  • Maintained front office cleanliness and organized supplies to increase [Type] task productivity.
Education and Training
Expected in 11/2017 to to
Certification: Medical Billing And Coding
Southern Careers Institute - Corpus Christi, TX,
GPA:
Expected in 05/2004 to to
High School Diploma:
Foy H. Moody High School - Corpus Christi, TX,
GPA:
Additional Information

I also have my notary stamp.

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Resume Overview

School Attended

  • Southern Careers Institute
  • Foy H. Moody High School

Job Titles Held:

  • Medical Coding and Billing Specialist
  • Medical Coding and Billing Specialist
  • Front Desk Receptionist

Degrees

  • Certification
  • High School Diploma

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