1300 Lane Street, City, CA 00000 Cell: 000-000-0000 Email: email@example.com
Precise, efficient medical billing professional with over 15 years of experience in inpatient, outpatient, and physician medical billing. Specialize in filing accurate claims, adjusting rejected claims, and understanding insurance contracts, appeals, and EOBs. Additional expertise in quality control, reimbursements, and implementing improved processes to enhance accuracy of business, billing, and medical records departments.
Medical Billing CPT and HCPCS Coding Posting and Balancing insurance Contracts, Appeals, EOBs Confidential Records Maintenance Accounts/Claims Reconciliation Quality Control Knowledge of HMOs, Medicare, and Medicaid
Gained expertise in all aspects of medical billing including filing claims, refund requests, re-filing rejected claims, completing appeals, and adjusting underpayments. Committed to staying up to date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service, and managed care plans. Improved medical center efficiency by creating an organized logging system for tracking registrar’s errors in Microsoft Excel as a QA Specialist at Affinity Medical Center. Liaised with the business and medical records departments to resolve errors in high dollar accounts to ensure timely and accurate billing.
Patient Representative October 2011 to January 2012 Mercy Medical Center Canton, OH Advocated for patients by contacting insurance companies to ensure timely payments and resolve errors on rejected claims. Diligently prepared all required claims documentation including referrals, treatment plans, or other required correspondence to reduce incidence of denials. Maintained accountability and accurate records by entering adjustments and denials into medical manager system and forwarding information to management to be applied. QA Specialist July 1980 to March 2009 Affinity Medical Center Massillon, OH Spearheaded quality control of data entry system holding patient registration, diagnoses, and insurance card information. Acted as a liaison between the business department, billing, and medical records to resolve billing errors and apply appropriate ICD-9, CPT-4, and HCPCS codes, charges, and corrected charges. Reimbursement Specialist Partnered with the business department, billing, and third party payers to ensure accurate billing, reimbursement, and filing of denied claims. Reviewed remittance codes from EOBs/ARs, and posted charges, payments, and adjustments. Stayed current with changes in HCPCs, CPTs, DRG, and reimbursement for Medicare and Medicaid for the Chargemaster. Medical Billing (Massillon Community Hospital) Performed full-cycle medical billing in a fast-paced company (formerly Massillon Community Hospital). Promoted continued accuracy by evaluating provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification, and provider signatures.