Medical Billing And Coding Specialist Resume Samples

Description :

1. Verified patient information and insurance details to ensure accurate billing.
2. Executed insurance verification, pre-certification, and pre-authorization processes efficiently.
3. Entered procedure and diagnosis codes into billing software with high accuracy.
4. Collaborated with clearinghouses to resolve claim submission issues promptly.
5. Maintained up-to-date knowledge of coding guidelines and insurance policies.
6. Conducted regular audits of billing records to ensure compliance and accuracy.
7. Trained new staff on billing procedures and coding standards to enhance team performance.

Experience

7-10 Years

Level

Management

Education

AAS

Description :

1. Coordinated charge entry for outpatient services, ensuring all data was inputted within a 5-day window.
2. Assisted departments in collecting necessary information for accurate billing and coding.
3. Managed verification, precertification, and preregistration for scheduled outpatient services.
4. Educated patients on HIPAA regulations and their rights regarding medical billing.
5. Ensured all physician notes were signed and documented accurately for billing purposes.
6. Input outpatient visit charges into the Citrix-IDX Charge Entry System, balancing batches before closing.
7. Verified CPT and ICD-10 codes for accuracy, ensuring proper billing and compliance.

Experience

2-5 Years

Level

Junior

Education

AAS-MBC

Description :

1. Conducted comprehensive audits of medical records for accuracy in coding across various specialties.
2. Ensured compliance with coding guidelines by reviewing documentation and applying appropriate ICD-10 and CPT codes.
3. Maintained up-to-date knowledge of coding regulations through continuous education and certification.
4. Collaborated with healthcare providers to clarify documentation and improve coding accuracy.
5. Utilized coding software to enhance efficiency and accuracy in billing processes.
6. Trained new staff on coding standards and billing procedures to ensure compliance.
7. Analyzed billing data to identify trends and implement improvements in revenue cycle management.

Experience

5-7 Years

Level

Executive

Education

AAS-MBC

Description :

1. Evaluated provider charges for accuracy, including service dates, procedures, and diagnoses.
2. Processed appeals and filed claims to ensure timely reimbursement.
3. Submitted refund requests for erroneous payments, enhancing financial accuracy.
4. Ensured timely charge submissions through electronic capture and clearinghouse systems.
5. Informed patients of financial responsibilities prior to service delivery, improving transparency.
6. Maintained up-to-date knowledge of insurance requirements and patient financial obligations.
7. Conducted quality control on data entry to verify correct posting of claims and payments.

Experience

2-5 Years

Level

Junior

Education

AAS in MBC

Description :

1. Investigated and resolved past due invoices, reducing unpaid accounts by 25%.
2. Reviewed medical records for accuracy, ensuring compliance with insurance requirements.
3. Examined diagnosis codes for accuracy and appropriateness based on services rendered.
4. Applied CPT, ICD-10, and HCPCS Level II coding into billing software, ensuring correct modifiers were used.
5. Obtained insurance authorizations for procedures, adhering to company protocols.
6. Verified patient information, collected copays, and informed patients of financial responsibilities.
7. Managed appeals for denied claims, achieving a 90% success rate in overturning decisions.

Experience

2-5 Years

Level

Executive

Education

AAS-MB

Description :

1. Accurately codes and bills medical claims for diverse healthcare providers, ensuring compliance with regulations.
2. Reviews medical records to identify appropriate coding based on CMS HCC categories, enhancing accuracy.
3. Verifies provider documentation and coding accuracy according to NCCI guidelines, improving claim acceptance rates.
4. Collaborates with healthcare professionals to obtain necessary patient information for accurate coding.
5. Performs administrative tasks, including data entry and managing patient records, to support billing processes.
6. Identifies and resolves discrepancies in billing, ensuring timely and accurate claims submission.
7. Provides exceptional customer service to patients regarding billing inquiries, enhancing patient satisfaction.

Experience

10+ Years

Level

Senior

Education

AAS-MBC

Description :

1. Enhanced revenue cycle by identifying discrepancies and ensuring accurate claims submission and documentation.
2. Accurately coded and billed medical claims, achieving a 98% first-pass resolution rate.
3. Conducted thorough research on new diagnoses and procedures to maintain coding accuracy.
4. Performed audits on CPT and ICD-10 codes to ensure compliance and maximize reimbursement.
5. Collaborated with healthcare providers to clarify billing policies and improve documentation practices.
6. Submitted electronic claims and managed follow-ups for timely processing and payment.
7. Resolved payment discrepancies and EOB rejections, improving account receivables.

Experience

5-7 Years

Level

Executive

Education

AAS in MBC

Description :

1. Trained and mentored new and existing staff on medical billing, coding, and claims processing.
2. Accurately coded all office visits and surgical procedures for a multi-physician practice.
3. Managed daily coding tasks, ensuring timely claim submissions and follow-ups.
4. Conducted charge reviews, claim submissions, and payment postings to maintain accurate patient accounts.
5. Analyzed claim denials and ensured compliance with CMS guidelines for accurate billing.
6. Entered and verified patient claims and demographic data to ensure accuracy and completeness.
7. Maintained up-to-date knowledge of coding regulations and billing practices to optimize revenue cycle.

Experience

2-5 Years

Level

Junior

Education

AAS-MB

Description :

1. Ensured the confidentiality and security of patient medical records in compliance with HIPAA regulations.
2. Reviewed and verified medical records for accuracy, completeness, and adherence to coding guidelines.
3. Coordinated with healthcare providers to retrieve necessary patient information for billing purposes.
4. Calculated and posted all services rendered, maintaining accurate financial records for the organization.
5. Compiled and maintained comprehensive patient records to support treatment documentation and quality improvement initiatives.
6. Processed business and government forms, ensuring timely patient admissions and discharges.
7. Conducted regular audits of billing processes to identify areas for improvement and enhance operational efficiency.

Experience

7-10 Years

Level

Management

Education

AAS-MB

Description :

1. Managed patient appointments and emergencies, ensuring compliance with established protocols.
2. Handled incoming calls, directing them to appropriate staff for efficient service.
3. Registered patients according to protocols, collecting necessary documentation for billing.
4. Generated route slips for patients, ensuring all services were accurately recorded.
5. Reviewed and verified insurance coverage, calculating patient charges accurately.
6. Collected co-pays and deductibles prior to patient visits, adhering to policies.
7. Informed patients of outstanding balances, collecting payments and issuing receipts.

Experience

10+ Years

Level

Senior

Education

AAS-MB

Description :

1. Reviewed insurance policies to determine coverage and eligibility for claims.
2. Prepared and submitted accurate insurance claim forms, ensuring completeness and compliance.
3. Contacted patients and insurance representatives to obtain missing information for claims processing.
4. Verified the accuracy of billing data and corrected discrepancies to maintain financial integrity.
5. Generated itemized statements and invoices, recording amounts due for services rendered.
6. Communicated with patients regarding account information and calculated claim amounts.
7. Analyzed operating costs and revenues to assist in setting competitive billing rates.

Experience

7-10 Years

Level

Management

Education

AAS-MB

Description :

1. Processed and submitted accurate medical claims to insurance providers, ensuring compliance with regulations.
2. Reviewed and corrected discrepancies in medical documentation to maintain coding accuracy.
3. Kept abreast of changes in coding guidelines and payer requirements to ensure compliance.
4. Managed follow-up on outstanding claims, reducing the average resolution time by 25%.
5. Performed detailed audits of medical records to ensure proper coding and billing practices.
6. Collaborated with healthcare providers to resolve billing inquiries and improve documentation.
7. Utilized coding software to assign appropriate codes for diagnoses and procedures.

Experience

7-10 Years

Level

Management

Education

AAS-MBC