Medical Reimbursement Specialist Resume Example Company Name

MEDICAL REIMBURSEMENT SPECIALIST

Summary

Qualified and hardworking Coding, Billing and Collections as a Reimbursement Specialist with expertise in policy research and customers service. Offering 1 years of experience in analyzing coverage and securing collection for claims. Excellent written and verbal communication skills. Committed Reimbursement Specialist with a recognized proficiency in client service and administrative support. Skilled in policy evaluation and negotiating claims. Offering a specialty in multiple insurance policies in addition to a general industry knowledgeability. I have experience from the start of Intake, then to Billing and my current role is in Collections, where I have had a very good success rate on getting unpaid claims that had been denied through the insurance payers.

Experience

Medical Reimbursement Specialist, 08/2021 - CurrentCompany Name - City, State

Maintained confidentiality and integrity of patient data.
Researched rejections, investigating problems to appeal claims.
Determined medical necessity, using individual insurance carrier regulations.
Verified technical reimbursement questions for providers, billing and coding staff.
Coded patient care records to provide accurate information for billing.
Worked with billing department to reduce contract implementation errors.
Drafted documents based on payer guidelines and submitted to necessary parties.
Identified opportunities for coverage access to address reimbursement barriers.
Collected coinsurance and deductibles from patients for rendered services.
Reviewed uninsured accounts, verifying medical assistance application process, charity care application and drug replacement program availability.
Managed all payments processing, invoicing and collections tasks.
Monitored past due accounts and pursued collections on outstanding invoices.
Reconciled codes against services rendered.
Checked claims coding for accuracy with ICD-10 standards.
Submitted claims to insurance companies.
Weighed envelopes containing statements to determine correct postage and affix postage.
Entered procedure codes, diagnosis codes and patient information into billing software, CareTend, to facilitate invoicing and account management.
Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
Reviewed legal claims for accuracy and issues.
Input statement information, reconciled accounts and resolved discrepancies.
Verified accuracy of information and resolved discrepancies with vendors before entering invoices for payment.
Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
Collected, posted and managed patient account payments.
Assessed billing statements for correct diagnostic codes and identified problems with coding.
Answered customer questions to maintain high satisfaction levels.
Executed account updates and noted account information in company data systems.

Territory Manager, 08/2019 - CurrentCompany Name - City, State

Increase sales revenue by 15% or more each fiscal year Manage a book of about 160 customers Develop and sustain relationships with existing customer base, building rapport as a personable and trusted representative Prepared customized client presentations and quotes Enthusiastically participated in sales training events and conferences to continuously develop skills and gain product knowledge.

Assistant General Manager, 09/2017 - CurrentCompany Name - City, State

Ensure front office is clean and presentable at all times Initiate and maintain trusting relationships with supervisors, coworkers, and customers Greet all customers with warm, friendly attitude Perform general clerical duties, including copying and faxing Manage bookkeeping efforts for the company Perform basic accounting services, including the handling of petty cash and invoicing Report a variety of data at the end of each month Maintain inventory records and place orders to restock supplies as needed Establish work duties and ensure workflow is properly followed Handle multi-line phone system efficiently Manage all day-to-day operations, including front desk, payment processing, scheduling, and more.
Managed store cash intake with high accuracy and prepared daily bank deposits.
Placed new inventory orders and oversaw correct restocking procedures to maintain operational output.
Supervised critical tasks, including budget implementations, employee reviews, training and scheduling for projects.
Motivated and led team members to work together to achieve targets.
Applied knowledge of coverage needs and individual employee strengths to produce successful team schedules.
Disciplined and maintained staff to deliver hospitable, professional service reflecting business initiatives.

Education and Training

High School Diploma, 08/2003

Northeast Lauderdale High School - City, State

Skills

Database updates
Check processing
Bill payment
Auditing proficiency
Debt management
Manual processing
Billing statement management

Account collections
Discrepancy reconciliation
Account updating
Payment transactions
Revenue forecasting
A/P and A/R proficiency

Resume Overview

School Attended

Northeast Lauderdale High School

Job Titles Held:

Medical Reimbursement Specialist
Territory Manager
Assistant General Manager

Degrees

High School Diploma , 08/2003

Medical Reimbursement Specialist Resume Example

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