Livecareer-Resume

Patient Account Rep Resume Example

Love this resume?

By clicking Build Your Own Now, you agree to our Terms of Use and Privacy Policy

Jessica Claire
Montgomery Street, San Francisco, CA 94105
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Professional Summary
Experience in administration, medical collections, medical billing, medical coding, cash handling, call center, bookkeeping and accounting, quality assurance, and customer service.Inpatient and outpatient records billing specialist with ICD-9, ICD-10 and CPT coding experience. Familiar with commercial and private insurance carriers. Seeks a position of increased responsibility and authority. Expertise includes verifying insurance coverage, records reviews, patient accounting, medical billing and schedule maintenance. Licenses Certified Medical Billing Specialist Medical Office Admin Certificate Skill Highlights Knowledge of HMOs, Medicare and Medi-Cal Medical Manager Software communication ICD-9 coding Exercises good judgment Electronic Medical Record (EMR) software Quality assessment of coded data CPT and HCPCS coding Maintains strict confidentiality Internal medicine billing
Professional Experience
05/2008 to 01/2015
Patient Account Rep Common Spirit Chattanooga, TN,
  • Call Center.
  • insurance adjustment.
  • Ability to problem solve and think critically.
  • Monitored shared email in-boxes and ensured inquiries were addressed.
  • Consistently ensured proper coding, sequencing of diagnoses and procedures.
  • Quickly responded to staff and client inquiries regarding CPT codes.
  • Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
  • Thoroughly reviewed remittance codes from EOBS/AR's.
  • Confirmed patient information, collected copays and verified insurance.Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
09/2006 to 06/2007
Claims Specialist Covenant Transportation Spartanburg, SC,
  • Posted charges, payments and adjustments.
  • Applied payments, adjustments and denials into medical manager system.
  • Submitted refund requests for claims paid in error.
  • Efficiently performed insurance verification and pre-certification and pre-authorization functions.
  • Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes. Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
06/2007 to 05/2008
Clinical Admin Coordinator United Healthcare Group City, STATE,
  • PreAuthorization for medical services and procedures Verbal and written communication skills as well as telephone etiquette skills.
  • Recorded and filed patient data and medical records.
  • Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate HCC information.Carefully reviewed medical records for accuracy and completion as required by insurance companies.Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) in support of existing diagnoses.
  • Strictly followed all federal and state guidelines for release of information.Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.Acquired insurance authorizations for procedures and tests ordered by the attending physician or hospital.
  • Accurately entered procedure codes, diagnosis codes and patient information into billing software.
  • Consistently ensured proper coding, sequencing of diagnoses and procedures.Quickly responded to staff and client inquiries regarding CPT codes.
  • Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
  • Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes.
  • Claim processor.
04/2015 to Current
Patient Account Representative/Billing Specialist CHRISTUS Health City, STATE,
  • Performs rebilling functions as appropriate and exhibits knowledge of UB04 and 1500 bill forms and filing requirements. Exhibits an understanding of CPT, HCPCS and ICD-10 coding regulations and guidelines. 
  • Medical collection functions as it relates to cash collections, aged accounts receivables and denials
  • Contact payers through written correspondence, on-line inquiries or phone to obtain claim status, clarification or to escalate resolution of patient accounts. Exhibits excellent verbal and written communication skills.
  • Responsible for researching and resolving accounts. Review proper account handling from admission through self pay collections and applies corrective actions as necessary.
  • Understanding of insurance denials and underpayments and routes account to proper department for assistance in resolution. Exhibits excellent problem solving skills.
  • Reviews account payment for accuracy utilizing an insurance explanation of benefits, on-line resources or contracts. Determines if balance should be moved to the next responsibility party. Able to resolve credit balances by determining if an account is overpaid or over adjusted.
  • Ensures proper reimbursement for all services. All appeals and/or refunds are filed timely in accordance with payer regulations or contracts.
  • Performs rebilling functions as appropriate and exhibits knowledge of UB04 and 1500 bill forms and filing requirements. Exhibits an understanding of CPT, HCPCS and ICD-10 coding regulations and guidelines.
  • Understands state insurance laws and the various appeals processes including but not limited to Insurance Commission filings.
  • Maintains thorough and detailed knowledge of state and fedecollection laws, third-party payer claims processing and appeal procedures as well as the different payment methodologies. Ensures compliance with state and federal laws regarding all cash collections activities.
Skill Highlights

Medisoft billing systems, Knowledge of Epic, Outlook, Microsoft Office Suite, HIPAA compliance, Kronos, GroupWise, NaviNet, Meditech, One Content, DCM Scanning System, Citrix, CUBS,Quick Books, SMS, Mistro, Peachtree, Power Point, Excel, Medisoft, AS400, Star, HCIS, EClinical Technical expertise Work 9.0, IPAYX, Invision, Kredo, IDX, C-Meds, Patient-focused care Care One, Care Planner, Cubs, Lotus, Sieman Strong work ethic Sorian, Medi- Fax and Right-Fax.

Education and Training
Expected in 2008
Medical coding and billing:
Texas School of Business - Houston, TX
GPA:
Health Information Administration coursework. Coursework in Healthcare Management Medical office Medical coding and billing
Expected in
Associate of Applied Science: Business Administration
Delgado Community College - New Orleans, LA
GPA:
Business Administration
Skills

By clicking Build Your Own Now, you agree to our Terms of Use and Privacy Policy

Disclaimer
Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

How this resume score could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:

70Average

Resume Strength

  • Personalization
  • Target Job

Resume Overview

School Attended
  • Texas School of Business
  • Delgado Community College
Job Titles Held:
  • Patient Account Rep
  • Claims Specialist
  • Clinical Admin Coordinator
  • Patient Account Representative/Billing Specialist
Degrees
  • Medical coding and billing
  • Associate of Applied Science

Similar Resume

View All
Patient Account Rep
Patient Account Rep III
PATIENT ACCOUNT REP/ COLLECTOR