senior medical billing and collection specialist resume example with 15+ years of experience
Jessica
Claire
resumesample@example.com
(555) 432-1000,
, , 100 Montgomery St. 10th Floor
:
Professional Summary
Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information. Reliable and competent Medical Billing professional with exceptional data entry and customer service skills. Knowledgeable Medical Billing Specialist specializes in Mental Health and Family Practice. Talented at correcting and resubmitting claims, preparing patient charts for registration and reviewing health records to identify proper relationships between procedure and diagnosis codes. Offers 10-year background in reviewing, analyzing and managing medical record information to identify appropriate coding. Competent Medical Billing Specialist with 10 years of experience in handling wide variety of medical coding and billing tasks. Sophisticated and hardworking individual with excellent analytical and multitasking abilities. Coordinates with insurance companies and expedites claims processes. Expertise in accurately inputting procedure and diagnosis codes into billing software to generate invoices. Expert Medical Biller successful in fast-paced, high-volume medical offices.
Skills
Medical terminology expert
Payment posting
Records Maintenance
Accounts receivable management
Collection calls
Medical coding knowledge
Medical record security
Medical claims submission
Mental Health/Nutritional Therapy/Dermatology/Family Practice billing knowledge
Data analysis
Patient account analysis
Proficiency in Athena/Kareo/RXNT/Medi Soft
Medicare and Medicaid process
Accounting systems and controls
Quality Assurance Management
Education
Mid America CollegeJeffersonville, IN, Expected in ā āAssociate of Science:Funeral Service And Mortuary Science - GPA:
Work History
W.R. Berkley Corporation - Senior Medical Billing and Collection Specialist Englewood, CO, 03/2020 - Current
Reviewed patient records, identified medical codes and created invoices for billing purposes.
Prepared billing statements for patients and verified correct diagnostic coding.
Communicated with insurance providers to resolve denied claims and resubmitted.
Trained new employees on multiple medical billing programs and data entry software.
Filed and updated patient information and medical records.
Reviewed patient diagnosis codes to verify accuracy and completeness.
Gathered information from multiple sources to simplify billing and organize accounts.
Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
Orchestrated medical coding, payment posting, accounts receivables and collections.
Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
Collected payments and applied to patient accounts.
Liaised between patients, insurance companies and billing office.
Delivered timely and accurate charge submissions.
Posted payments and collections on regular basis.
Set up and maintained new electronic billing system.
Prepared accounts with past due balances and transferred those cases to collection agency.
Adhered to established standards to safeguard patients' health information.
Managed billing calendar and scheduled claims for payments.
57Implemented improvements in manual and electronic billing procedures.
Determined liability outlined in coverage and assessed documentation from healthcare providers to understand charges being billed for.
Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
Evaluated all information provided with ultimate goal of creating positive outcomes for client's claims.
Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
Collaborated with claims department to resolve claims.
Maintained claims data in EHR systems.
Conducted day-to-day administrative tasks to maintain information files and process paperwork.
Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
Examined claims forms and other records to determine insurance coverage.
Reconciled data in direct collection system with accounting system to address discrepancies.
Addressed average of 150 customer inquiries and complaints each week
Nursecore - Medical Billing and Collections Specialist Dallas, TX, 02/2015 - 12/2018
Compiled and tracked outstanding balances owed to medical facilities.
Processed online and paper appeal submissions and refund requests.
Assisted in reconciling deposit and patient collections.
Logged charges and payments within Next Gen.
Processed billing calls and answered questions from patients and third-party carriers.
Corrected, completed and processed claims for multiple payer codes.
Generated accounts payable reports for management review to aid in financial and business decision making.
Responded to customer concerns and questions on daily basis.
Developed rapport with clients and vendors to cultivate loyalty and satisfaction.
Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
Processed payment via telephone and in person with focus on accuracy and efficiency.
Used data entry skills to accurately document and input statements.
Managed invoicing and payment processing operations.
Executed billing tasks and recorded information in company databases.
Generated financial statements and reports detailing accounts receivable status
Trained and mentored new team members and managers on accounts payable systems and policies to build cohesive groups and promote operational performance.
Utilized talents and expertise to complete on-time and accurate monthly closing processes, journal entries and accruals.
Logged charges and payments within Next Gen.
Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
Entered orders into EMR system efficiently and without errors.
Used Next Gen to input information into computerized patient record system.
Scanned and filed medical records in alphabetical order to maintain organized and up-to-date filing system.
Interacted with physicians and other healthcare staff to ask questions regarding patient services.
Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
Used Next Gen to assign procedure and diagnostic codes to patient records for billing purposes.
Processed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
Reviewed patient charts to better understand health histories, diagnoses and treatments.
Managed efficient and accurate processing of invoices and check requests for 5 locations
Dr John Daniel, MD - Medical Billing and Collections Specialist City, STATE, 03/2006 - 12/2014
Compiled and tracked outstanding balances owed to medical facilities.
Processed online and paper appeal submissions and refund requests.
Assisted in reconciling deposit and patient collections.
Logged charges and payments within Athena.
Processed billing calls and answered questions from patients and third-party carriers.
Corrected, completed and processed claims for multiple payer codes.
Developed rapport with clients and vendors to cultivate loyalty and satisfaction.
Used data entry skills to accurately document and input statements.
Managed invoicing and payment processing operations.
Executed billing tasks and recorded information in company databases.
Handled account payments and provided information regarding outstanding balances.
Monitored outstanding invoices and performed collections duties.
Generated financial statements and reports detailing accounts receivable status
Trained and mentored new team members and managers on accounts payable systems and policies to build cohesive groups and promote operational performance.
Utilized talents and expertise to complete on-time and accurate monthly closing processes, journal entries and accruals.
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