Medical Billing And Coding Specialist Resume Samples

Description :

1. Confirmed patient information with doctors' office and by calling patients as needed.
2. Efficiently performed insurance verification and pre-certification and pre-authorization functions.
3. Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification, and provider signature.
4. Examined diagnosis codes for accuracy, completeness, specificity, and appropriateness according to services rendered and assigned additional codes and modifiers in support of existing codes.
5. Accurately entered procedure codes, diagnosis codes and patient information into billing software.
6. Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house.
7. Communicated with a clearinghouse to resolve issues in claim submission.
8. Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.

Experience

7-10 Years

Level

Management

Education

Education

Description :

1. Coordinated the input of all charges for the Department was keyed within a 5 day window.
2. Assisted the departments with effectively collecting all information that need to be inputted each day.
3. Responsible for coordinating the verification, precertification and preregistration for all scheduled outpatient services Balanced and closed all charge and payment batches by the end of day.
4. Explain HIPPA, Bill of Rights and Patient Rights and Responsibilities to all patients schedule for surgery.
5. Ensuring the Attending Physician has signed all Resident notes for patients that they examined with Resident.
6. Responsible for inputting outpatient office visit charges into Citrix-IDX Charge Entry System and that each Batch was balance before closing batch.
7. Verified CPT and ICD-9 codes and modifiers if necessary were properly coded so that encounter could be billed.
8. Responsible for working Missing Charges Report by locating missing charges daily to cut down on charge lag.

Experience

2-5 Years

Level

Junior

Education

Medical Office Management

Description :

1. Audited charts for OB-Gyn, Pain management, Orthopedic surgeon, Family practice, Internal Medicine.
   
2. Ancillary coding for General Surgery Made sure that E/M levels and modifiers, ICD-9 codes were correct according to the documentation.
3. Followed the 1995 guidelines Op notes were audited to make sure the correct CPT codes were captured.
4. Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical documentation.
5. Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
6. Performed qualitative analysis of records to ensure accuracy, internal consistency and correlation of recorded data.
7. Accurately selected the proper descriptive code when more than one anatomical location was indicated.

Experience

5-7 Years

Level

Executive

Education

Medical Administrative

Description :

1. To Position of Medical Billing and Coding Present Evaluated the accuracy of provider charges, including dates Of service, procedures, level of care, locations, diagnoses, Patient identification and provider signature.
2. Completed appeals and filed submitted claims.
3. Submitted refund requests for claims paid in error.
4. Ensured timely and accurate charge submission through electronic charge capture, including the billing and account Receivables (BAR) system and clearing house.
5. Consistently informed patients of their financial responsibility Prior to services being rendered.
6. Remained uptodate with all insurance requirements, Including the details of patient financial responsibilities, Feeforservice and managed care plans.
7. Performed quality control of the data entry system to verify That claims and payments were posted correctly.

Experience

2-5 Years

Level

Junior

Education

Diploma

Description :

1. Investigated past due invoices to minimize the number of unpaid accounts.
2. Carefully reviewed medical records for accuracy and completion as required by insurance companies.
3. Examined diagnosis codes for accuracy, completeness, specificity, and appropriateness according to services rendered.
4. Applied CPT, ICD-9, and HCPCS Level II coding, as well as patient information, into billing software adding necessary modifiers when needed.
5. Acquired insurance authorizations for procedures ordered according to insurance company requirements.
6. Confirmed patient information, collected copays, verified insurance and notified patients of financial responsibility prior to having services rendered.
   
7. Completed appeals for all denied claims and prior authorizations.

Experience

2-5 Years

Level

Executive

Education

Medical Billing

Description :

1. Correctly codes and bills medical claims for various hospital physician billing.
2. Conscientiously reviewed medical record information to identify appropriate coding based on CMS HCC categories.
3. Verifies provider documentation and coding is correct according to NCCI Obtained information about clients' medical history, drug history, complaints and allergies.
4. Scheduled and accompanied clients to medical appointments.
5. Performed clerical duties, such as word processing, data entry, answering phones and filing.
6. Reported any unusual circumstances in the patients' condition or environment.
7. Managed wide variety of patient service and administrative tasks to resolve patient issues quickly and efficiently.
8. Greeted patients entering the office to ascertain what each patient wanted or needed.

Experience

10+ Years

Level

Senior

Education

Human Sciences

Description :

1. Improved revenue for group practice by identifying and rectifying inconsistencies and precisely completing appropriate claims paperwork, documentation and system entry.
2. Correctly coded and billed medical claims for group practice.
3. Researched newly identified diagnoses and/or medical procedures to expand skills and knowledge.
4. Audited CPT and ICD-9, ICD-10 coding discrepancies for compliance and reimbursement accuracy.
5. Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.
6. Submitted electronic/paper claims documentation for timely filing.
7. Posted and reconciled insurance and patient payments.
8. Researched and resolved incorrect payments, EOB rejections, and other issues with outstanding accounts.

Experience

5-7 Years

Level

Executive

Education

Registered Medical Assistant

Description :

1. Trained new employees, as well as retrained existing employees, on data entry, claim entry, billing, coding, and follow-up.
2. Responsible for coding all office visits and surgical procedures performed by a six physician medical practice specializing in general surgery.
3. Performed day-to-day functions associated with coding and claim submission.
4. Able to perform charge review, claim submission, claim follow-up, claim appeals, payment posting and patient statements.
5. Ensured that claim denials received from payors were correctly denied based on either CMS (Center for Medicare and Medicaid Services) guidelines &/or their published billing guidelines.
6. Entered and verified patient claims and demographic data.
7. References and additional work experience available upon request.

Experience

2-5 Years

Level

Junior

Education

Theatre

Description :

1. Protected the security of medical records to ensure that confidentiality is maintained.
2. Reviewed records for completeness, accuracy, and compliance with regulations.
3. Retrieved patient medical records for physicians, technicians, or other medical personnel.
4. Entered data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment into computer.
5. Calculated, posted and verified all services to obtain financial data for maintaining accounting records.
6. Compiled and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts.
7. Processed and prepare business / government forms, patient admission or discharge documents.

Experience

7-10 Years

Level

Management

Education

Vocational In Medical Billing

Description :

1. Schedule appointments; direct walk-in patients and emergencies as per established policies and Procedures.
2. Answer all incoming calls and route them to the Appropriate staff.
3. Register all patients per registration protocols an Collect all documentation.
4. Generate route slips for each patient, and assure that All services provided have been checked out properly.
5. Reviews and verifies patient coverage of insurance or other agencies and computes the charges to be paid by the patient.
6. Collected deposits or co-pays/deductibles prior to the patient being seen by the provider per established policies and procedures.
7. Inform patient of their outstanding balance, collect said balance, and issue cash receipt when monies are collected.

Experience

10+ Years

Level

Senior

Education

Business Management

Description :

1. Reviewed insurance policy to determine coverage.
2. Prepared insurance claim forms or related documents and review them for completeness.
3. Contacted insured or other involved persons to obtain missing information.
4. Verified accuracy of accounting records and billing data and revise any errors.
5. Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
6. Contacted customers to obtain or relay account information; calculate amount of claims.
7. Reviewed compiled data on operating costs and revenues to set rates.
8. Entered data, such as demographic characteristics, history and extent of disease, diagnostic procedures, or treatment into computer.

Experience

7-10 Years

Level

Management

Education

Certificate In Medical Billing

Description :

1. Completed appropriate claims paperwork, documentation and system entry.
2. Identified and corrected inconsistencies, deficiencies and discrepancies in medical documentation.
3. Maintained updated knowledge of coding requirements.
4. Filed and followed up on third party claims.
5. Coded Observation/Inpatient Physician Services and daily office visits.
6. Perform qualitative analysis of records to ensure accuracy, internal consistency and correlation of recorded data.
7. Researched questions and concerns from providers and provided detailed responses.
8. Accurately selected the proper descriptive code when more than one anatomical location was indicated.

Experience

7-10 Years

Level

Management

Education

Health Information Technology