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Radiation Cancer AR Specialist Resume Example

Resume Score: 90%

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RADIATION CANCER AR SPECIALIST
Professional Summary
Service-oriented Billing Specialist with 20 year background in medical billing. Core competencies include Internal Medicine, Podiatry, Cardiology, Radiation Oncology and Hospitalist billing as well as excellent communication and time management skills. Handles tasks with accuracy and efficiency.
Education and Training
Bachelor of Science : Healthcare Administration Management Healthcare Administration Management Social WorkUniversity Of Phoenix Borough of Manhattan Community College - City, StateHealthcare Administration Management Healthcare Administration Management Social Work
Associate of Science
Professional Experience
Radiation Cancer AR Specialist
April 2014 to May 2015
Company Name - City, State
  • Contact insurance companies to check on status of Radiation Cancer claims payments and write appeal letters for denial on claims.
  • Sort and file correspondence, and perform miscellaneous clerical duties such as answering correspondence and writing reports.
  • Complete insurance or other claim forms.
  • Transmit correspondence or medical records by mail, e-mail, or fax.
Claims Examiner
April 2013 to March 2014
Company Name - City, State
  • Examined Humana and AIG supplemental Cancer claims based on policy provisions.
  • Process and review claims for any pre-existing conditions.
  • Process contestability reviews Process all incoming correspondence Assess patient calls Analyzed and interpreted patient medical and surgical records to determine payable services Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
  • Strictly followed all federal and state guidelines for release of information.
AR Representative
September 2011 to February 2013
Company Name - City, State
  • Strictly followed all federal and state guidelines for release of information.
  • Consistently ensured proper coding, sequencing of diagnoses and procedures.
  • Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
  • Analyzed and interpreted patient medical and surgical records to determine billable services.
  • Interpreted medical reports to apply appropriate ICD-9, CPT and HCPCS codes.
  • Thoroughly reviewed remittance codes from EOBS/AR's.
  • Confirmed patient information, collected copays and verified insurance.
  • Completed appeals and filed and submitted claims.
  • Posted charges, payments and adjustments.
  • Submitted refund requests for claims paid in error.
  • Meticulously tracked and resolved underpayments.
  • Consistently informed patients of their financial responsibilities prior to services being rendered.
  • Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.
  • Efficiently performed insurance verification.
Office Administrator
February 2011 to September 2011
Company Name - City, State
  • Responsible for the setup of a new practice that focuses its care on low vision rehabilitation.
  • Setup Office Electronic Medical Records System Set up Practice Management System Established and setup Office Merchant account Set up office Inventory Tracking System Over all did everything for the practice and addressed any area with precision and expedience, from assessing technical issues to office Maintenance.
Medical Insurance Collector
September 2009 to July 2010
Company Name - City, State
  • Following up on unpaid accounts or denying claims for their status Filed appeals for all denied claims Work special insurance reconciliation spread sheets for resolution of old unpaid claim issues.
  • Look up IDC-9 codes to verify if code has been changed.
  • Verify insurance payments were made based upon the provider's contracted fee schedule as well as confirm the insurance contractual adjustments are loaded correctly.
AR Representative
June 2005 to June 2009
Company Name - City, State
  • Charge Entry for Hospitalist, Podiatry, and Sleep Study Verify procedure-diagnosis relationship Process claims for either electronic or paper billing Research and respond to patient inquiries regarding billing issues and insurance problems.
  • Maintained supporting documentation and patient insurance demographics and data collection systems.
  • Following up on unpaid accounts or denying claims for their status.
  • Monitor unpaid claims, initiate tracers.
  • File dispute and/or appeals to insurance companies for resolution of claims.
  • Resubmit claims as needed.
  • Balance daily batches and reports.
  • Ensure strict confidentiality of financial records.
  • Perform miscellaneous job-related duties as assigned.
  • Oversee physicians to make sure they are submitting charges timely for proper billing guidelines.
Professional Affiliations
Member of American College of Healthcare Executives (ACHE) The Alliance of Professional Health Advocates (APHA) Sep 2015
Skills
AR, Balance, billing, Cancer, Clerical, CPT, Critical Thinking, data collection, Decision Making, diagnosis, documentation, Electronic Medical Records, Electronics, e-mail, fax, financial, forms, ICD-9, insurance, Inventory, letters, Medical billing, Medical coding, mail, Office, Personnel, coding, rehabilitation, Repairing, Research, spread sheets, Time Management, vision
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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.

Resume Overview

School Attended

  • University Of Phoenix Borough of Manhattan Community College

Job Titles Held:

  • Radiation Cancer AR Specialist
  • Claims Examiner
  • AR Representative
  • Office Administrator
  • Medical Insurance Collector

Degrees

  • Bachelor of Science : Healthcare Administration Management Healthcare Administration Management Social Work
    Associate of Science

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