Billing Specialist Resume Samples

Description :

1. Processed payments from EOBs for various insurance carriers, ensuring accurate posting.
2. Corrected patient demographic and insurance data entry errors to maintain clean claims.
3. Generated financial reports to assess the impact of payment rule changes on receivables.
4. Followed up with insurance companies and patients to expedite payment on outstanding receivables.
5. Presented on ABN forms at annual meetings, enhancing staff understanding of compliance.
6. Updated beneficiary notice forms to align with current Medicare guidelines.
7. Created a Medicare LCD diagnosis sheet for use by billing and technical staff.

Experience

0-2 Years

Level

Entry Level

Education

AAS-B

Description :

1. Processed primary and secondary insurance claims accurately and promptly, utilizing electronic billing systems and ensuring compliance with all billing forms.
2. Maintained knowledge of federal and state billing regulations, ensuring all authorizations are completed and following up on missing requirements.
3. Conducted thorough audits of billing statements to identify and rectify errors, ensuring accurate documentation of adjustments.
4. Secured and maintained medical documentation to support claims and appeals, ensuring compliance with regulatory standards.
5. Resolved claim errors efficiently by analyzing error reports and implementing corrective actions.
6. Documented all billing activities meticulously, including bill dates and notes, to maintain accurate records.
7. Balanced billing systems daily, ensuring all claims were submitted correctly and timely.

Experience

5-7 Years

Level

Executive

Education

AAS

Description :

1. Managed monthly journal entries and reconciled accounts to ensure accurate financial reporting.
2. Reviewed daily balancing and closing reports, ensuring compliance with internal controls.
3. Analyzed accounts for coding accuracy and resolved discrepancies promptly.
4. Acted as a liaison for accounts payable, handling patient billing and insurance inquiries.
5. Demonstrated exceptional multitasking skills while managing high-volume phone inquiries.
6. Coordinated with insurance companies to follow up on claims, ensuring timely payments.
7. Monitored accounts receivable reports to maintain cash flow and timely filing of claims.

Experience

5-7 Years

Level

Executive

Education

B.S. Accounting

Description :

1. Managed billing processes, ensuring timely invoicing and follow-up on unpaid claims to enhance cash flow.
2. Entered and reconciled financial data in the accounting system, maintaining accuracy and compliance.
3. Generated and tracked invoices, monitoring collection progress to meet departmental goals.
4. Created quarterly and annual financial reports to assess billing performance and identify trends.
5. Streamlined data entry processes, improving efficiency in record-keeping and reporting.
6. Communicated with clients to resolve billing inquiries and outstanding payments, fostering positive relationships.
7. Collaborated with cross-functional teams to address billing discrepancies and enhance service delivery.

Experience

10+ Years

Level

Consultant

Education

BSA

Description :

1. Managed billing department functions, including medical billing, charge entry, and payment posting to enhance invoicing accuracy.
2. Responded to inquiries regarding CPT and diagnosis codes, ensuring clarity and compliance.
3. Verified diagnosis codes on patient encounter forms, reconciling codes with services rendered.
4. Accurately input procedure and diagnosis codes into billing software, generating timely invoices.
5. Utilized electronic charge capture practices to submit codes and invoices promptly, improving cash flow.
6. Followed up on past-due invoices and delinquent accounts, reducing unpaid balances by 25%.
7. Conducted routine audits of patient data and medical records to comply with insurance requirements.

Experience

5-7 Years

Level

Executive

Education

AAS-Billing

Description :

1. Posted payments from patients and payors, ensuring accurate month-end processes and reporting.
2. Negotiated non-par agreements and collaborated with collection agencies on overdue accounts.
3. Managed aged accounts for Medicare and Anthem Blue Cross, supporting the team with other commercial accounts.
4. Executed electronic fund transfers for Medicare, Anthem, Aetna, and Medicaid, ensuring timely processing.
5. Collaborated with billing supervisors to verify claims for prompt payment and accuracy.
6. Maintained monthly performance goals based on charge percentages and historical data.
7. Educated patients on their insurance policies to enhance understanding and resolve unpaid claims.

Experience

10+ Years

Level

Consultant

Education

AAS-MB

Description :

1. Provided comprehensive billing support for client companies, ensuring accurate invoicing and timely payments.
2. Established and maintained strong relationships with Medicare partners and commercial insurance carriers to facilitate smooth billing processes.
3. Collaborated with skilled nursing facilities to resolve denied charges, improving overall claim acceptance rates.
4. Effectively addressed payment gaps and billing disputes, advising clients on optimal solutions for outstanding balances.
5. Decreased cash posting backlogs by 40% through efficient processing of refunds and account adjustments.
6. Reduced denials for skilled nursing facility charges by over 65% through targeted appeals and documentation.
7. Enhanced the accuracy of billing processes by communicating effectively with utilities and clients regarding charge discrepancies.

Experience

5-7 Years

Level

Executive

Education

B.S. in BA

Description :

1. Managed patient billing inquiries, providing clear explanations of charges and payment responsibilities.
2. Assisted patients in understanding their bills, including copayments, deductibles, and insurance coverage.
3. Collected and verified insurance information to ensure accurate claim submissions.
4. Confirmed patient eligibility and service dates for accurate billing and claims processing.
5. Generated patient statements and appealed unpaid claims with insurance providers.
6. Handled funded accounts, ensuring timely payments from pharmaceutical companies.
7. Utilized Microsoft Office and billing software to maintain accurate records and reports.

Experience

2-5 Years

Level

Junior

Education

AAS-Billing

Description :

1. Generated and analyzed commercial, Medicaid, and workers' compensation insurance reports bi-monthly.
2. Coordinated with insurance companies to verify medical claims status and ensure prompt reimbursements.
3. Negotiated with insurers and third-party administrators to maximize claim reimbursements.
4. Reviewed explanations of benefits, corrected claims, and resubmitted for processing.
5. Prepared and submitted appeal letters for denied claims, advocating for higher reimbursements.
6. Followed up with insurers to confirm receipt of appeal letters and check their status.
7. Posted insurance and patient payments, managing outstanding balances efficiently.

Experience

7-10 Years

Level

Senior

Education

AAS

Description :

1. Managed comprehensive billing operations, ensuring accurate coding for HCPCS and ICD-10 codes, and timely submission of claims.
2. Trained new staff on billing software and claim submission processes, enhancing team efficiency.
3. Submitted clean DME claims to Medicare, both electronically and via paper, ensuring compliance with regulations.
4. Conducted follow-ups with Medicare and insurance companies to resolve payment issues and denials.
5. Executed collection actions, including patient outreach and payment information updates, to improve cash flow.
6. Maintained accurate patient profiles to ensure correct billing and compliance with HIPAA regulations.
7. Performed audits on billing and reimbursement processes, ensuring accuracy in accounts payable and receivable.

Experience

5-7 Years

Level

Executive

Education

AAS-B

Description :

1. Generated invoices upon receipt of billing information and tracked collection progress.
2. Entered financial data into the company accounting database to be verified and reconciled.
3. Tracked financial progress by creating quarterly and yearly balance sheets.
4. Streamlined daily reporting information entry for efficient record-keeping purposes.
5. Managed and responded to all correspondence and inquiries from customers and vendors.
6. Entered financial information and payments to guarantee that employees and vendors were paid accurately and on time.
7. Communicated with customers to identify and resolve outstanding payments.

Experience

2-5 Years

Level

Junior

Education

Certificate In Business

Description :

1. Validated network carrier billings.
2. Maintained database with payment and dispute Information.
3. Interacted with other departments to maintain network integrity.
4. Coordinated efforts of in-house vendors and outside contractors.
5. Coordinated interdepartmental effort to enhance the verification of active circuits, which also identified dead circuits.
6. Occurred on these dead circuits were credited back to the company.
7. Verified pricing and determined if pricing was within allowed levels.

Experience

7-10 Years

Level

Consultant

Education

Finance

Description :

1. Ensured the completeness and accuracy of billing documents.
2. Created, reviewed, completed, and corrected all third party and individual claims.
3. Processed insurance claim forms.
4. Responsible for electronic billing: includes reviewing edits and rejections stemming from electronic billing submissions and the correction and resubmission of same.
5. Generated secondary insurance bills for the portion of bill not covered by primary insurance.
6. Responsible for on going review of accounts receivable off of the aging reports.
7. Responded to inquiries related to billing with patients, doctors, and insurance companies.

Experience

10+ Years

Level

Senior

Education

Associate Of Arts

Description :

1. Manages the delivery of contracted services to clients to ensure that service level agreements and key performance indicators as defined in the relevant contracts and leases are met or exceeded.
2. Ensures that implementations and ongoing services are delivered on time and meet client requirements by maintaining control over the project schedule, risks, the scope of work and budget.
3. Serves as a primary point of contact for client requests, reports, billings, assignment of resources, productivity analysis, data integrity and quality standards to meet client needs.
4. Builds and maintains strong client relationships, and participates in client meetings regarding performance to ensure client satisfaction.
5. Processes and trains of new hires to include professional orientation and project assignments.
6. Able to define problems, collect data, establish facts, and draw valid conclusions.
7. Produces invoices as well as distributes and mails the invoices to the concerned person.

Experience

10+ Years

Level

Senior

Education

Associate Of Science

Description :

1. Managed and collaborated with management in developing plans to reduce aging of medical accounts over 90 days for 6 medical practices.
2. Reviewed third party payers Aged Trial Balance Report to locate and resolve unpaid medical claims.
3. Met established follow -up productivity goal of completing 200 claims per week.
4. Assured accounts are completed and worked at a high level of quality by visually proofreading and monitoring work output.
5. Analyzed and Interpreted client metrics to management in order to identify trends, which help AMN make necessary adjustments in a dynamic environment.
6. Partnered with Production Systems Analyst as backup on billing production schedule to include API transmission and Accounts Receivable and Sales postings to Great Plains software to ensure business efficiency and strengthen cooperation among departments.
7. Maintained carious Sarbanes-Oxley (SOX) controls by reconciling data and processes with company.

Experience

5-7 Years

Level

Executive

Education

Business Administration