Medical Biller Resume Samples

Description :

1. Managed billing operations, ensuring accurate charge entry and timely submission of claims to insurance providers.
2. Communicated effectively with patients to clarify billing inquiries and explain insurance coverage details.
3. Processed insurance and patient payments, maintaining accurate records of transactions.
4. Conducted follow-ups on outstanding accounts receivable, maximizing revenue recovery for the practice.
5. Utilized CPT and diagnosis codes for accurate billing, ensuring compliance with industry standards.
6. Assisted front desk operations, enhancing patient experience through efficient service.
7. Performed administrative tasks, including filing and correspondence, to support billing functions.

Experience

10+ Years

Level

Senior

Education

AAS-MB

Description :

1. Managed surgical billing reports to ensure timely submissions and accurate reimbursements.
2. Reviewed explanations of benefits for errors and denials, ensuring correct payment adjustments.
3. Submitted appeals for denied claims, adhering to AMA guidelines and contractual agreements.
4. Communicated with insurance carriers to verify claim statuses and resolve discrepancies.
5. Developed spreadsheets to track incorrectly paid claims, facilitating corrections for proper reimbursements.
6. Conducted thorough reviews of charge reports to identify and rectify billing errors prior to submission.
7. Coordinated with surgical schedules to confirm patient insurance benefits and necessary authorizations.

Experience

7-10 Years

Level

Executive

Education

AAS-MB

Description :

1. Verified and created claim numbers by effectively communicating with various insurance companies.
2. Conducted thorough audits of customer files to ensure medical necessity and compliance with coverage criteria.
3. Contacted patients regarding unpaid and underpaid accounts, resolving issues efficiently.
4. Reviewed medical records for completeness and organized files in both alphabetical and numerical order.
5. Input charges into billing systems weekly, collecting payments from patients for office visits.
6. Determined prior authorizations for medications and outpatient procedures, ensuring timely approvals.
7. Collaborated with providers and medical professionals on billing and documentation policies and regulations.

Experience

10+ Years

Level

Senior

Education

AAS-MB

Description :

1. Assign and audit diagnostic and procedure codes for Medicaid and Medicare claims.
2. Oversee chart completion, coding accuracy, and patient information privacy compliance.
3. Collaborate with patient accounts to resolve billing discrepancies and claim denials.
4. Review medical documentation to ensure clarity and adequacy for coding purposes.
5. Contributed to successful JCAHO inspections by maintaining compliance with standards.
6. Recognized for excellence in records management, enhancing JCAHO survey outcomes.
7. Maximized reimbursements through precise coding and regular audits of provider documentation.

Experience

7-10 Years

Level

Executive

Education

AAS-MB

Description :

1. Managed billing for Medicare, Medicaid, and commercial insurance, ensuring compliance with regulations.
2. Entered patient demographics, verified diagnosis codes, and maintained accurate electronic health records.
3. Analyzed billing and claims for accuracy, submitting claims to appropriate insurance carriers and resolving issues.
4. Followed up on denials and unpaid claims, enhancing cash flow and reimbursement rates.
5. Processed physical and electronic check payments through integrated systems, ensuring accurate posting.
6. Generated monthly AR reports to identify trends and manage denials, appeals, and refunds.
7. Verified patient eligibility, obtained prior authorizations, and managed single case agreements.

Experience

10+ Years

Level

Senior

Education

AAS-MB

Description :

1. Accurately completed claims paperwork and documentation, ensuring compliance with regulations.
2. Maintained and updated electronic medical records, enhancing data accuracy and accessibility.
3. Verified patient eligibility and claims status with insurance providers to expedite processing.
4. Conducted thorough research on CPT and ICD-10 coding discrepancies to ensure reimbursement accuracy.
5. Reviewed patients' insurance coverage and deductibles to inform billing practices.
6. Posted surgeries and hospital visits accurately for assigned insurance carriers.
7. Generated and analyzed monthly aging reports to follow up on overdue payments.

Experience

10+ Years

Level

Senior

Education

AAS-MB

Description :

1. Processed and submitted insurance claims, ensuring compliance with regulations and accuracy.
2. Managed accounts receivable, reducing outstanding balances by 25% through effective follow-up.
3. Investigated and resolved billing discrepancies, improving patient satisfaction.
4. Verified patient insurance coverage and collected necessary information for claims.
5. Implemented office policies to streamline billing and payroll processes.
6. Posted patient charges and generated claims for electronic submission.
7. Processed over 1,000 claims monthly, achieving a 98% approval rate on first submission.

Experience

2-5 Years

Level

Junior

Education

AAS-MB

Description :

1. Processed and submitted medical claims to insurance companies, ensuring compliance with regulations and accuracy in coding.
2. Reviewed and corrected billing discrepancies, resulting in a 15% reduction in denied claims.
3. Managed patient accounts, including payment posting and follow-up on outstanding balances.
4. Collaborated with healthcare providers to gather necessary documentation for claims processing.
5. Conducted regular audits of billing practices to ensure adherence to industry standards.
6. Maintained up-to-date knowledge of insurance policies and coding guidelines to optimize billing efficiency.
7. Provided exceptional customer service by addressing patient inquiries regarding billing and insurance coverage.

Experience

10+ Years

Level

Management

Education

AAS-MB

Description :

1. Managed clinical and facility billing processes, including UB-04 submissions.
2. Adjusted patient accounts, posted charges, followed up on payments, and printed statements.
3. Prepared itemized statements and invoices, accurately recording amounts due for services rendered.
4. Reviewed documents to compute fees and charges, ensuring accuracy in billing.
5. Performed bookkeeping tasks, maintaining records of costs and services.
6. Typed and processed billing documents, ensuring compliance with regulations.
7. Verified patient insurance coverage and eligibility, authorizing claims as needed.

Experience

10+ Years

Level

Senior

Education

AAS-MB

Description :

1. Ensured accuracy and compliance of insurance payments with contractual agreements.
2. Managed timely completion and submission of billing, collections, and accounts receivable.
3. Processed commercial insurance, MCOs, and patient billing efficiently.
4. Reviewed patient bills for accuracy, ensuring all necessary information was obtained.
5. Maintained communication with clinic staff regarding billing and patient account issues.
6. Reduced claim denial rates by 15% through meticulous coding and documentation review.
7. Implemented new billing software, increasing processing efficiency by 30% within six months.

Experience

10+ Years

Level

Senior

Education

AAS-MB

Description :

1. Maintain patient financial accounts and arrange for the collection of payment.
2. Handle day-to-day medical billing procedures by completing HCFA 1500 claim forms and billing insurance companies for reimbursement of services rendered by Physicians.
3. Document everything done to a patient in patient's electronic medical record.
4. Assigning proper codes to medical tests, treatments, procedures and other clinical activities.
5. Submitting claims to Insurance companies or Medicare in order to receive payment for services provided to a patient by a Physician.
6. Contacting insurance companies for information regarding outstanding claims.
7. Correcting HCFA1500 forms and resubmitting filing claims electronically and paper.
8. Maintain reports and EOB's from insurance companies.

Experience

5-7 Years

Level

Executive

Education

Associates In Business

Description :

1. Providing accurate claims processing, prompt responses, and clear communication; increasing client reimbursements and patient satisfaction.
2. Data entry, general office administrative support such as answering multi-line phones and sending faxes.
3. Provided support to billing managers with accounts receivable, patient issues, and collections.
4. Followed instructions to create and maintain meticulous spreadsheets, performed research projects, and contacted insurance companies to gain information about unpaid claims.
5. Prepared, tracked, and sent weekly and monthly reports and data to clients.
6. Maintained a comprehensive filing arrangement.
7. Demonstrate patience and care when addressing patient questions/concerns while adhering to all HIPAA guidelines and regulations.

Experience

5-7 Years

Level

Executive

Education

Associate Of Science

Description :

1. Working directly with the insurance company, healthcare provider and patient to get a claim processed and paid.
2. Responsible for following up with the insurance companies.
3. Answers questions from patients, clerical staff and insurance companies.
4. Identifies and resolves patient billing complaints.
5. Evaluates the patient's financial status and establishes budget payment plans.
6. Follows and reports the status of delinquent accounts.
7. Contact customers to obtain or relay account information.

Experience

7-10 Years

Level

Management

Education

Medical

Description :

1. Process and follows up on submitted claims and unpaid claims in a timely manner.
2. Apply payments promptly when payments are received.
3. Prepare and process patient reimbursements to ensure receipt of payments from insurance/third parties/patients.
4. Routinely monitor and assess the collection ability of AR balances.
5. Work Aging Report Accounts Analyzes, works, and appeals denials from EOB's and correspondence daily.
6. Read & interpret various insurance EOB's including Medicare.
7. Knowledge of Cerner Works Medical Software Corrects payment posting errors.

Experience

5-7 Years

Level

Executive

Education

Diploma In Medical