Livecareer-Resume

Physician Billing Specialist Resume Example

Love this resume?

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

JC
Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
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
07/2020 to Current Physician Billing Specialist Children's Hospital Boston | Boston, MA,
  • 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.
07/2012 to 07/2020 Office Coordinator Ashford University | Chandler, AZ,
  • 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.
  • Collaborated closely with Director of Operations to effectively smooth and improve office operations.
  • Collaborated closely with Director of Operations to effectively smooth and improve office operations.
07/2007 to 07/2012 Medical Billing Coordinator New York Institute Of Technology | Jonesboro, AR,
  • 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
Expected in 06/1993 High School Diploma | Chesapeake Senior High, Baltimore, MD, GPA:

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:

83Good

Resume Strength

  • Formatting
  • Length
  • Measurable Results
  • Personalization
  • Strong Summary
  • Target Job

Resume Overview

School Attended
  • Chesapeake Senior High
Job Titles Held:
  • Physician Billing Specialist
  • Office Coordinator
  • Medical Billing Coordinator
Degrees
  • High School Diploma