Biller Resume Profile

Summary

Seven years of medical hospital billing, two years of hospital medical coding and abstracting from operative notes. Diverse understanding of CPT, HCPCS, ICD-9 coding and medical terminology. Knowledgeable of Medicare, Medi-cal/Medicaid rules and regulations. In-depth understanding of Supplemental, HMO, PPO, Commercial and Private insurance claim filing.

Computer skills

Windows Microsoft Office
Software: MS Word, MS Excel V-Lookups, Pivot Tables, Charts, formulas, etc. , MS Access, MS PowerPoint, MS Outlook
Work Systems: Emdeon Clearinghouse, Greenway and Meditech.

Employment History

Confidential

Commercial Medical Biller

Monitor daily reports to confirm the receipt of electronic claims
Work insurance and patient Accounts Receivables, including the follow-up of unpaid accounts
File all facility claims electronically through third party
Audit and rebill previously denied claims.
Perform day to day functions associated with coding, abstracting claim errors
Manage 10 hospital facilities on a daily basis
Bill 75 patient accounts per day while maintaining a 98 accuracy

Confidential

Medical Insurance Biller

Audited accounts ensuring accuracy among other billers
Verified insurance, and abstracted all medical data from resident accounts
Reviewed DRG discrepancies
Corrected submitted claims on a UB and 1500 forms
Posted payments refunds and adjustments to resident accounts
Interpreted Explanation of Benefits EOB's
Handled denied claims, and processed appeals

Confidential

Medical Accounts Receivable Consultant

Audited accounts ensuring accuracy among other billers
Prepared invoices
Contacted patients regarding billing errors or past due bills.
Collecting payments, making adjustments
Interpreted explanation of Benefits EOB's
Handled denied claims, and processing appeals
Medi-cal/HMO billing and collections and follow-up

Confidential

Medical Biller Office Manager

Medicare/Medi-cal/HMO billing and collections and follow-up
Triple Check Medicare Claims verifying Rugs Score and charges.
Account auditing i.e. research underpayments and overpayments from Medicare/HMO, Medi-cal by auditing the EOB's
Submitted Credit Balance Reports to the intermediary
Collected and posted payments refunds including adjustments to resident accounts
Data entry of supplies and services

Confidential

Medical Insurance Biller

Medicare/Medi-cal billing and collections
Verified payments by reviewing the remittance advice and/or explanation of benefits
Posted payments for ancillary charges i.e. radiology, laboratory, medical supplies and pharmacy charges to resident ledgers
Audited accounts for refunds and adjustments

Confidential

Customer Service Insurance Rep

Answered heavy incoming calls in call center environment
Verified customer benefits
Claims inquiry
Received and responded to correspondent
Open and close accounts

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