reimbursement specialist resume example with 6+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • :

Detail-oriented receptionist organizes files and communications. Supports office operations with clerical expertise and strong follow-through on daily tasks and open issues. Brings excellent understanding of medical terminology, coding and billing practices.

  • Medical/DME/Pharmaceutical claims
  • Clerical writing
  • Bill payment
  • Customer relations
  • Mail sorting
  • Discrepancy reconciliation
  • Manual processing
  • Year-end reporting
  • Payment transactions
  • Account collections
  • Billing statement management
  • Account updating
  • Policy evaluation
  • Client service
  • Quality control
  • Administrative skills
  • Correspondence typing
  • Call routing
  • Listening skills
  • Cash transactions
  • Appointment confirmation
  • Recordkeeping
  • Oral and writing communication
  • Team collaboration
Reimbursement Specialist, 08/2012 to 05/2016
Francisan HealthWest Lafayette, IN,
  • Maintained confidentiality and integrity of patient data.
  • Researched rejections, investigating problems to appeal claims.
  • Determined medical necessity, using individual insurance Jessicar regulations.
  • Verified technical reimbursement questions for providers, billing and coding staff.
  • Coded patient care records to provide accurate information for billing.
  • Educated physicians, staff, patients and stakeholders on service documentation for procedures and coding requirements.
  • Drafted documents based on payer guidelines and submitted to necessary parties.
  • Identified opportunities for coverage access to address reimbursement barriers.
  • Worked with billing department to reduce contract implementation errors.
  • Verified clients' [Type] insurance claims coverage by coordinating with providers.
  • Processed invoice payments and recorded information in account database.
  • Managed all payments processing, invoicing and collections tasks.
  • Monitored past due accounts and pursued collections on outstanding invoices.
  • Expedited payments by verifying accuracy and currency of vendor information.
  • Assessed billing statements for correct diagnostic codes and identified problems with coding.
  • Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
  • Enforced compliance with organizational policies and federal requirements regarding confidentiality.
  • Verified accuracy and integrity of motor vehicle and workers' compensation claims through careful research and analysis.
  • Verified accuracy of information and resolved discrepancies with vendors before entering invoices for payment.
  • Input statement information, reconciled accounts and resolved discrepancies.
  • Submitted claims to insurance companies.
  • Answered customer questions to maintain high satisfaction levels.
  • Completed efficient drop and bulk filing to maintain well-organized and easily accessed systems
  • Collected, posted and managed patient account payments.
  • Checked claims coding for accuracy with ICD-10 standards.
  • Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
  • Performed insurance verification, pre-certification and pre-authorization.
  • Executed account updates and noted account information in company data systems.
  • Developed strong professional rapport with vendors and clients.
  • Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
Front Desk Receptionist, 05/2012 to 08/2012
Kiosk Information SystemsLouisville, CO,
  • Handled payment processing and provided customers with receipts and proper bills and change.
  • Welcomed patrons to front desk and engaged in friendly conversations while conducting check-in process.
  • Prepared daily shift close reports and balanced cash register to accurately reflect all transactions.
  • Scheduled and confirmed appointments.
  • Answered and directed incoming calls using multi-line telephone system.
  • Answered phone calls, provided information to callers and connected callers to appropriate people.
  • Answered office phone and emails to schedule appointments, forward information and complete [Task].
  • Greeted incoming patients and verified paperwork to manage smooth intake processes.
  • Processed payments and updated accounts to reflect balance changes.
  • Pulled and organized requested documentation.
  • Maintained front office cleanliness and organized supplies to increase [Type] task productivity.
  • Oversaw office inventory by restocking supplies and submitting purchase orders.
  • Entered data in [Type] software to keep records of [Type] information.
  • Applied knowledge of medical terminology and insurance processes to support office administration productivity.
  • Assisted current and prospective patients with navigating telephone and web-based support systems.
  • Managed office duties and basic administrative tasks, organized and cleaned work space, ordered materials and answered phone calls.
  • Prepared and communicated treatment plan instructions for patients to facilitate at-home and continuing care.
  • Worked with office manager to attain operational goals.
Collections Specialist, 01/2010 to 05/2012
Capital VacationsSapphire, NC,
  • Remained calm, stayed professional and provided exceptional service on calls, even when interacting with difficult individuals.
  • Processed payments over phone and set up recurring drafts.
  • Recorded and updated customer personal accounts with accurate contact information.
  • Met demands of busy collections group by performing high volume of daily calls.
  • Reviewed accounts to determine payment plan compliance.
Education and Training
Certificate : Medical Billing And Coding, Expected in 01/2010 to Pittsburgh Technical College - Oakdale, PA

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Resume Overview

School Attended

  • Pittsburgh Technical College

Job Titles Held:

  • Reimbursement Specialist
  • Front Desk Receptionist
  • Collections Specialist


  • Certificate

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