Medical Insurance Biller resume example

• Kept municipal operations in compliance with all city ordinances, state requirements and federal laws.
• Appointed and managed department heads to maintain smooth operations between different functional areas.
• Co-created annual budget and submitted it to city council for review and approval.
• Calculated population trends to forecast future growth and strategically develop land according to needs.
• Evaluated development plans against city regulations and available data.
• Pursued learning opportunities and maintained current understanding of trends and technological advances in municipal management.
• Monitored and supported bidding and proposal process.
• Worked alongside stakeholders to evaluate projects and determine feasibility of implementation.
• Represented city and interests with community organizations, government agencies and general public.
• Conducted studies to assess feasibility of renewal, development and other community plans.
• Adhered to applicable local, state and federal regulations governing land use and growth.
• Researched issues, wrote reports and presented findings to city council.
• Maintained department productivity and standards through proactive management of teams and policies.
• Prepared plans for land use, area development, and urban revitalization.
• Developed comprehensive performance reports using Google Analytics to strategize resource allocation and establish performance metrics for clients.
• Developed program to promote new managers from within, building and maintaining cohesive leadership structure.
• Aligned organizational objectives with company mission, increasing revenue, profit and business growth by collaboratively developing integrated strategies.
• Developed and implemented new strategies and policies in collaboration with executive partners to establish and achieve long-term business objectives, providing company with strong and sustainable organizational leadership.
• Achieved under-budget and on-time project management to adhere to project goals.
• Conducted research on emerging trends within industry and capitalized on finds to develop new products, services and strategies.
• Integrated new media and web advertising initiatives into client's marketing strategies to enhance brand awareness.
• Directed technological improvements, reducing waste and business bottlenecks.

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• Initiated operational improvements using lean methodologies to drive efficiency and reduce costs.
• Fostered new business through participation in trade shows and initiating communications with prospective clients via phone and email .

• Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
• Conducted routine facility inspections, identifying areas needing improvement and eliminating hazards posed to staff and residents for continued compliance with associated regulations.
• Implemented best practice standards for billing resulting in substantial reduction of accounts receivable delays.
• Produced monthly financial reports like income statements, balance sheets and cash flow statements for presentation to board of directors.
• Scheduled surgeries, managed pre-certifications and verified insurance coverage.
• Generated and reviewed incident reports, including employee write-ups, actualizing appropriate corrective action plans to mitigate ongoing and potential situations.
• Discussed medical histories with patients in effort to provide most effective medical advice.
• Created customized care plans, working with hospital staff and families to assess and meet individual needs.
• Removed trash and straightened counters to keep pharmacy area clean and neat.
• Communicated with patients, ensuring that medical information was kept private.
• Devised and introduced initiatives and projects to maintain or improve existing facilities, allowing for maximization of capital component of Medicaid's per diem rate.
• Offered patients and patrons information on various immunizations including flu, DTaP and HPV vaccines.
• Monitored and inspected staff processes to eliminate hazards posed for both residents and staff while ensuring continuous compliance with regulations.

• Entered orders into EMR system efficiently and without errors.
• Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.
• Accurately selected proper descriptive code when more than one anatomical location was indicated.
• Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
• Utilized active listening, interpersonal and telephone etiquette skills when communicating with others.
• Scanned and filed medical records in alphabetical order to maintain organized and up-to-date filing system.
• Interacted with physicians and other healthcare staff to ask questions regarding patient services.
• Verified signatures and checked medical charts for accuracy and completion.
• Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures.
• Resourcefully used various coding books, procedure manuals and on-line encoders.
• Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
• Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
• Reviewed patient charts to better understand health histories, diagnoses and treatments.
• Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.

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