LiveCareer-Resume

Medical Insurance Biller resume example with 20+ years of experience

Jessica
Claire
resumesample@example.com
(555) 432-1000,
, , 100 Montgomery St. 10th Floor
:
Professional Summary

Reliable and competent Medical Billing professional with exceptional data entry and customer service skills.

Organized Medical Biller adept at accurately auditing patient charts and billing corresponding parties.

Reliable Medical Biller with coding and medical terminology knowledge. Polished and hardworking performer with a background overseeing accounts and handling records management tasks. Considered a team-oriented person with great decision-making skills.

Skills
  • Payment posting
  • Medical record security
  • Data Analysis
  • Patient account analysis
  • Billing knowledge
  • Great Customer Service
  • Detail Oriented
  • Records Maintenance
  • Medical claims submission
  • Medical coding knowledge
  • Medical terminology expert
  • Accounts receivable management
  • Budgeting proficiency
  • Payment processing
  • Cost accounting
  • Vendor invoice processing
  • Sheet balancing
  • Budgeting
  • Accounting remittances
  • General accounting
  • Financial Management
  • Financial statement analysis
Education
Moore High Moore, Oklahoma, Expected in 05/1994 General Diploma : - GPA :
Work History
Avalon Health Care Group - Medical Insurance Biller
Bountiful, UT, 07/2017 - 11/2019
  • Reviewed patient records, identified medical codes and created invoices for billing purposes.
  • Liaised between patients, insurance companies and billing office.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
  • Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.
  • Reviewed patient diagnosis codes to verify accuracy and completeness.
  • Researched and followed up on denied insurance claims.
  • Posted payments and collections on regular basis.
  • Complied with all HIPAA Privacy and Security Regulations to protect patients' medical records and information.
  • Participated in workshops and other training opportunities to remain current on billing procedures, regulations and industry updates.
  • Prepared billing statements for patients and verified correct diagnostic coding.
  • Scanned and filed medical records in alphabetical order to maintain organized and up-to-date filing system.
  • Maintained current accounts through aged revenue reporting.
  • Transferred balances to correct payers.
  • Followed up on legal claims.
  • Managed billing calendar and scheduled claims for payments.
  • Communicated with insurance providers to resolve any denied claims and resubmit.
  • Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures.
  • Adhered to established standards to safeguard all patients' health information.
  • Verified signatures and checked medical charts for accuracy and completion.
  • Orchestrated day-to-day operations of billing department, including medical coding, payment posting, accounts receivables and collections.
  • Gathered information from multiple sources to simplify billing and organize accounts.
  • Posted charges, payments and write-ups for cardiovascular procedures.
  • Filed and updated patient information and medical records.
  • Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
  • Enforced operational compliance with state and federal laws and JCAHO standards.
  • Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
  • Analyzed medical records to satisfy insurance company mandates.
  • Submitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
  • Reviewed outgoing bills for eligibility and accurateness.

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International City Management - Town Manager
Caledonia, MI, 01/2012 - 07/2017
  • 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 .
Dana-Farber Cancer Institute - Clinic Coordinator
Boston, MA, 01/2007 - 07/2017
  • 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.
Integris - Medical Coding Associate
City, STATE, 05/1999 - 01/2012
  • 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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Resume Overview

School Attended

  • Moore High

Job Titles Held:

  • Medical Insurance Biller
  • Town Manager
  • Clinic Coordinator
  • Medical Coding Associate

Degrees

  • General Diploma

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