Medical Claims and Billing Specialist Resume Example

Highly skilled and analytical Medical Claims and Billing Specialist has excellent billing formularies knowledge and significant experience working in hospital environments.Possesses strong chart auditing and application of federal standards for appropriate coding practices.Has an Associate’s degree in Medical Billing and Coding AIHMA CCS certification and more than eleven years of Medical Claims and Billing Specialist experience.

• Extensive knowledge of ICD-9 CPT4 HCPCS and DRG billing and coding
• Good knowledge of medical and surgical terminology and disease process as related to coding
• Excellent interpersonal and oral communication skills
• Efficient medical documentation auditing for code appropriateness and guidelines
• Thorough understanding of contract Medicaid and Medicare reimbursement terminology
• Above-average auditing skills

• Coded provided services using ICD9 CPT4 HCPCS and DRG billing formularies.
• Kept abreast of federal coding requirements and guidelines.
• Submitted bills for reimbursement to private insurers Medicaid and Medicare.

• Randomly audited charts for accuracy of coding as assigned.
• Reported any coding issues to management.
• Entered appropriate medical codes into the hospital’s billing system.
• Maintained chart records and billing records and maintained confidentiality.

2003 Certified Coding Specialist- American Health Information Management Association (AHIMA)