Medical Billing Specialist Resume Profile
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RD
Objective: To secure a position within the company, that will utilize my current skills, and with growth and development provide for advancement.
Years of Experience:
Total: 9 Years
- 6 years Medical Office Experience
- 5 years Provider Medical Billing/ Coding Experience
- 5 years Support and Back-up to Management and Administration
- 1 year Insurance Company Experience
- 1 year Quality Assurance Experience
- 1 Year System Testing Experience
Insurances I have experience with:
Medicare Part A B, Medicaid, Tricare, Tricare for Life, and commercial plans
Computer Systems I have experience with:
- Medical Office Systems: All-Scripts Mysis Compu-Systems, All-Scripts Payer Path, Digichart EHR , and AdvancedMD
- Insurance Company Systems: Processing Claims on Medicaid WebTool, Tricare Claims Entry and Medicare FISS Shared System
- Palmetto GBA Systems: Webport, ITS, Appeals, and I-Flow
- CGS Administrators: OnBase
Employment History:
CONFIDENTIAL
Medical Billing Specialist/ Coder
Job Description:
- Billing for an OB/GYN client
- Posted Office Charges and Hospital Charges
- Coded Inpatient and Outpatient charges
- Ensured Office and Hospital Charges were coded properly if coded by office staff
- Insurance A/R Follow-up
CONFIDENTIAL
J15 Claims Team Lead
Job Description:
- Processed Complex Claims
- System Testing with the Tech Support Teams
- Ensured staff was on task with daily assignments
- Provided Management with SNAP Reports identifying the work loads
- Assigned daily work
- Provided Training and Support to Staff
- Responded to Provider Inquiries
CONFIDENTIAL
J15 Claims Team Lead
Job Description:
- Processed Complex Medicare Part A Claims Inpatient, SNF, and Outpatient Ancillary
- System Testing with the Tech Support Teams
- Ensured staff was on task with daily assignments
- Provided Management with SNAP Reports identifying the work loads
- Assigned daily work
- Provided Training and Support to Staff
- Responded to Provider Inquiries
- Key and process Appeals claims
CONFIDENTIAL
Claims Processor II
Job Description:
- Processed Complex Medicare Part A Claims Inpatient, SNF, and Outpatient Ancillary
- Review and Work RAC Audit Claims
- Respond to Provider Inquiries
- Back-Up to Project Administrator, Team Lead, and Management
- Run reports for Daily, Weekly, Monthly and Quarterly Metrics
- Complete project spreadsheets and prepare them for Senior Management
- Lead for the Therapy Cap implementation project for the Claims Department
- Assist with Voluntary refunds, correcting provider claims and reviewing timely filing claims
CONFIDENTIAL
Job Description:
- Posted Patient and Insurance Checks
- Posted Hospital, Office and Ambulatory Surgical Center Charges
- Physician Credentialing
- Back-up to the Billing Supervisor and Administrative Assistant
- Ensured coding was accurate
- Assisted Check- In and Check Out
- Started working in the Phone Room and was promoted to billing
CONFIDENTIAL
Appointments/Floater
Job Description:
- Answering phones
- Scheduling appointments
- Completed Pregnancy Short-Term Disability Forms
- Assisted OB check-out and Triage Nurses when needed
- I started working here in Medical Records filing records
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