LiveCareer-Resume

patient account rep resume example with 8+ years of experience

Jessica
Claire
resumesample@example.com
(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
:
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

Medical Office Admin Certificate

Certified Medical Billing Specialist

Computer Skills
  • Epic
  • Outlook
  • Microsoft Office Suite
  • Kronos
  • GroupWise
  • NaviNet
  • NaviLine
  • Quick Books
  • Medical billing software
  • SMS
  • Maestro
  • Peachtree
  • Power Point
  • Excel
  • MediSoft
  • AS400
  • Star
  • Care One
  • Care Planner
  • Cubs
  • Lotus
  • Sorian
  • Medi- Fax
  • Right-Fax
  • AS400
  • Star
  • Meditech
  • HCIS
  • EClinical
  • Work 9.0
  • IPAYX
  • Invision
  • IDX
  • C-Meds
Education and Training
Texas School of Business Houston, TX Expected in 2008 Medical coding and billing : Billing and Coding - GPA :

Health Information Administration coursework.

Coursework in Healthcare Management

Medical office

Medical coding and billing

Delgado Community College New Orleans, LA Expected in Associate of Applied Science : Business Administration - GPA : Business Administration
Skill Highlights
  • Patient-focused care
  • Strong work ethic
  • Team player with positive attitude
  • Deadline-driven
  • Good written communication
  • Managed care contract knowledge
  • Electronic Medical Record (EMR) software
  • ICD-9 coding
  • Knowledge of HMOs, Medicare and Medicaid
  • Maintains strict confidentiality
  • CPT and HCPCS coding
  • HIPAA compliance
  • Technical expertise
  • Exercises good judgment
Professional Experience
Common Spirit - Patient Account Rep
Gilbert, AZ, 2014 - 01/2015
  • 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
Common Spirit - Patient Account Rep
Lake Jackson, TX, 04/2008 - 09/2013
  • Call Center
  • Provides administrative support to Supervisors and additional staff Gathers information, researches/resolves inquiries
  • Manage Outlook calendar and meeting request for staff
  • Provides functional guidance, training and assistance
  • Medical Terminology, Verify Insurance information
  • Filed documents and maintained patient records
  • Thoroughly investigated past due invoices and minimized number of unpaid accounts
  • Recorded and filed patient data and medical records.
United Healthcare Group - Clinical Admin Coordinator
City, STATE, 05/2007 - 04/2008
  • 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
Medical Claim Services - Claim Processor
City, STATE, 08/2006 - 05/2007
  • Posted charges, payments and adjustments
  • Applied payments, adjustments and denials into medical manager System
  • Submitted refund requests for claims paid in error
  • Carefully prepared, reviewed and submitted patient Statements
  • Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials
  • Efficiently performed insurance verification and pre-certification and pre-authorization functions
  • Performed full-cycle medical billing in a fast-paced medical billing company
  • Completed appeals and filed and submitted claims
  • Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature
  • Confirmed patient information, collected copays and verified insurance
  • Thoroughly reviewed remittance codes from EOBS/AR's
  • Interpreted medical reports to apply appropriate ICD-9, CPT-4 and HCPCS codes
  • Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses
  • Analyzed and interpreted patient medical and surgical records to determine billable Services
  • Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative
  • Received, organized and maintained all coding and reimbursement periodicals and updates

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Resume Overview

School Attended

  • Texas School of Business
  • Delgado Community College

Job Titles Held:

  • Patient Account Rep
  • Patient Account Rep
  • Clinical Admin Coordinator
  • Claim Processor

Degrees

  • Medical coding and billing
  • Associate of Applied Science

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