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Physician Billing Specialist Resume Example

Resume Score: 80%

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AH
PHYSICIAN BILLING SPECIALIST
Summary

Organized Medical Biller boasts 25-year career performing difficult multitasking and claims-processing tasks. Works quickly and efficiently with insurance companies to resolve problematic disputes and handle patient inquiries. Brings can-do attitude to collaborating with medical professionals, insurance providers and clients to handle invoicing within high-traffic office environment.

Skills
  • Claim review
  • Knowledgeable in Athena, Centricity and eCW
  • Athena use
  • Medical coding understanding
  • CPT code modifiers
  • Account follow-up
  • Data entry
  • Submission of medical claims
  • ICD-10 coding
  • Billing codes
  • Insurance claims
Experience
Company Name | City, StatePhysician Billing Specialist07/2020 - Current
  • Reviewed medical records to meet insurance company requirements.
  • Assessed medical codes on patient records for accuracy.
  • Filed and submitted insurance claims.
  • Completed and submitted appeals.
  • Used Athena system to manage provider schedules.
  • Assigned Physician Quality Reporting System (PQRS) codes appropriately.
  • Utilized electronic charge capture systems to consolidate and streamline billing processes.
  • Added modifiers, coded narrative diagnosis and verified diagnoses.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Applied HIPAA Privacy and Security Regulations while handling patient information.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Maintained accurate and timely charge submissions utilizing electronic charge capture practices, including billing and account receivables (BAR) system and medical billing clearinghouse accounts.
  • Addressed and responded to staff and client inquiries regarding CPT and diagnosis codes.
  • Reviewed all claims for accurateness and appropriateness.
  • Researched and communicated insurance requirements, including patient financial responsibilities and fee-for-service
  • Effectively coordinated all communications between patients, billing personnel and insurance carriers.
Company Name | City, StateOffice CoordinatorNaN NaN - NaN NaN
  • Organized workloads to streamline tasks and efficiently oversee day-to-day operations under tight deadlines.
  • Balanced and updated computer accounting records and physical petty cash, including receipt documentation and expense tracking.
  • Documented daily office activities in report logs for senior management review, smoothly implementing suggested operational changes to eliminate process gaps.
  • Guided team members to minimize delays and maintain high-quality daily production.
  • Supported internal team members with technical knowledge, operational support and exemplary customer service.
  • Developed and implemented customer relations strategies, opening up communication to increase satisfaction scores.
  • Adhered to data confidentiality practices, coordinated meetings and maintained heavy daily call volumes by leveraging strong multitasking and task prioritization skills.
  • Input accurate account data to efficiently update company database and maintain detailed records.
  • Instructed new hires on administrative procedures and company policies, closely checking work to verify performance.
  • Backed up human resources department in handling benefits paperwork, employee incident reports and data entry to maximize team productivity.
  • Collaborated closely with the Director of Operations to effectively smooth and improve office operations.
  • Managed incoming and outgoing correspondence and packages to support smooth daily operations.
  • Supported office needs including taking messages, scanning documents and routing business correspondence.
  • Cultivated client loyalty and consistent referrals by proficiently managing customer relationships.
  • Assigned projects to administrative staff, boosting office productivity and streamlining processes.
  • Supervised medical office with 8 employees, consistently cultivating productive and positive work atmosphere.
  • Developed long-term budgets covering office supplies and equipment maintenance to meet organizational demand.
Company Name | City, StateMedical Billing CoordinatorNaN NaN - NaN NaN
  • Expertly assigned charges and payments for medical procedures.
  • Assessed medical codes on patient records for accuracy.
  • Reviewed medical records to meet insurance company requirements.
  • Addressed and responded to staff and client inquiries regarding CPT and diagnosis codes.
  • Maintained knowledge of new or revised codes and industry regulations to complete accurate coding services, including local coverage determinations.
  • Reviewed all claims for accurateness and appropriateness.
  • Applied HIPAA Privacy and Security Regulations while handling patient information.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Managed benefit contract pricing, processing, policies and procedures.
  • Maintained accurate and timely charge submissions utilizing electronic charge capture practices, including billing and account receivables (BAR) system and medical billing clearinghouse accounts.
  • Assigned CPT procedure and evaluation and management (E&M) codes for services to assure appropriate billing and reimbursement.
  • Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
  • Added modifiers, coded narrative diagnosis and verified diagnoses.
  • Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
  • Effectively coordinated all communications between patients, billing personnel and insurance carriers.
  • Performed routine quality assurance audits to promote data integrity.
  • Verified final claim submissions by comparing account charges with documentation.
  • Documented and filed patient data and medical records.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Researched and rectified account discrepancies.
  • Utilized electronic charge capture systems to consolidate and streamline billing processes.
  • Completed and submitted appeals.
  • Performed with precision by entering data accurately and researching to resolve questions.
  • Researched and communicated insurance requirements, including patient financial responsibilities and fee-for-service
  • Investigated denials and collaborated with internal team members and third-party representatives to identify solutions.
  • Filed and submitted insurance claims.
Education and Training
Chesapeake Senior High | CityHigh School Diploma06/1993
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Resume Overview

School Attended

  • Chesapeake Senior High

Job Titles Held:

  • Physician Billing Specialist
  • Office Coordinator
  • Medical Billing Coordinator

Degrees

  • High School Diploma

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