Medical Biller Resume Samples

Description :

1. Ready to multitask, such as answer and operate 6 or more phone lines, have great communication skills when talking to doctors.
2. Working with patients to be able to help them understand the reasons for their medical bills and help them understand their insurance policies with what is and is not covered.
3. Responsible for charging entry and posting of insurance and patient payments.
4. Responsible for working accounts receivable to recover the most money for each practice and physician.
5. Finding CPT codes and diagnosis codes out of books and utilize the internet when needed is also a daily task I perform.
6. Picking up more hours and helping with the responsibilities of front desk and billing.
7. Performing general administration duties such as filing, faxing and typing various correspondences.
8. Answering mail or telephone inquiries regarding rates, routing, or procedures.
9. Typing billing documents, shipping labels, credit memorandums, or credit forms, using typewriters or computers.

Experience

10+ Years

Level

Senior

Education

Certification

Description :

1. Surgical biller work reports in a timely manner to ensure proper billing and correct reimbursement.
2. Receive an explanation of benefits for review for errors, denials, adjustments, correct reimbursement of payments.
3. Submit appeals needed for denied procedures that are reimbursable according to ama guidelines and contracts.
4. Contact insurance carriers to check status, correct and resolve billed claims.
5. Create spreadsheets for incorrectly paid claims to inform provider representatives where there may be an error in their system to correct to receive proper reimbursements according to contracts.
6. Review of charge reports catching billing errors before a claim is submitted to the insurance carrier.
7. Review of surgical schedule for any changes in schedule and ensure that the patient's carrier has been contacted for benefits, the patient has been contacted to review their benefits, referrals, notifications, authorizations are on file as needed.
8. Posting of charges after the surgical packet has been coded and reviewed.
9. Forwarded messages from the liaison department for confirmation that information given to patient and carrier is correct.
10. Collections to include a review of patient accounts to send out first and final collections letter or offer payment plans as needed.

Experience

7-10 Years

Level

Executive

Education

Associate

Description :

1. Verifying and creating claim numbers by communicating with various insurance companies.
2. Auditing new customer files to verify medical necessity and satisfaction of coverage criteria.
3. Contacting patients regarding unpaid and underpaid accounts to resolve any issues.
4. Reviewing medical records for completeness and filed records in alphabetic and numeric order.
    
5. Inputs charges into aps systems weekly, collected payments from patients for doctor visits and daily office visits.
6. Precisely completing appropriate claims paperwork, documentation and system entry.
7. Verifying patients' eligibility and claims status with insurance agencies.
8. Determining prior authorizations for medication and outpatient procedures.
9. Interacting with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.

Experience

10+ Years

Level

Senior

Education

HS

Description :

1. Select, assign and audit diagnostic and procedure codes to patient records for Medicaid and Medicare.
2. Manage chart completion (ICD-9-cm and CPT coding/abstracting), chart assembly and analysis, patient admission and patient information privacy/security.
3. Work collaboratively with patient account d to ensure accurate billing and resolve claim denials and medical-necessity issues.
4. Review medical documentation and when documentation is inadequate/unclear for coding purposes.
5. Selected contributions: helped hospital pass JCAHO inspections by consistently meeting JCAHO requirements.
6. Earned employee-recognition award in 2004 for accurate records management contributing to positive JCAHO survey.
7. Maximized reimbursement by ensuring accurate ICD-9-cm and CPT coding and conducting regular quality audits of providers' selected codes compared to chart documentation.
8. Ensured records met quality and risk-management requirements by participating in the hospital chart review committee.
9. Provided ongoing on intricacies of insurance submissions, codes and intake procedures to minimize rejections for a referral- or registration-related reasons.

Experience

7-10 Years

Level

Executive

Education

BBM

Description :

1. Experience with Medicare, Medicaid, Medicare replacement plans, and commercial insurance.
2. Enter patient demographics, verify diagnosis codes, create paper charts, and file documents accordingly.
3. Analyze billing and claims for accuracy and completeness; submit claims to proper insurance carriers and follow up on any issues.
4. Followed up on denials and unpaid claims to ensure maximum cash flow and reimbursement.
5. Capable of running and posting physical and electronic check payments through integrated systems.
6. Monthly a/r reports to identify trends, work with denials, appeals, refunds, and insurance balances.
7. Verify patient eligibility, obtain prior authorizations and single case agreements.
8. Assisted with payroll, created a spreadsheet for HR to verify payroll items, reconcile month end between the billing dept.
9. Multi-line phone e-mails, faxes, scanning images, written and verbal communication with providers, insurance carriers and other team members.
10. Answer phones customer service sent out patient statements solved all insurance issues by phone or rebilling posted monies from insurance companies.

Experience

10+ Years

Level

Senior

Education

Diploma

Description :

1. Precisely completing appropriate claims paperwork, documentation and system entry.
2. Coding and billing of medical claims for various hospital and nursing facilities.
3. Rsearch newly identified diagnoses and/or medical procedures to expand skills and knowledge, assisting in the maintenance of medical charts and/or electronic medical record (filing, op reports, test results, home care forms).
4. Verifying patients' eligibility and claims status with insurance agencies.
5. Research CPT, and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
6. Examining patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable.
7. Accurately posting surgeries, hospital visits and payments for assigned carriers.
8. Printing and reviewing the monthly patient aging report and solicited overdue payments.
9. Responsible for scrubbing claims through system software HCS using interactant.
10. Providing all necessary follow-up including collections on outstanding claims.

Experience

10+ Years

Level

Senior

Education

BS

Description :

1. Worked directly with the insurance companies, paralegals, attorneys, healthcare providers, and patients to get a claim processed and paid.
2. Handled collections on unpaid accounts managed the facility's accounts receivable/payable reports.
3. Served as the first point of contact for recognizing and investigating any billing issues, problems, and procedural adjustments directly related to billing and collections.
4. Registered the patients and verified their insurance coverage, collected the information required to create a pip claim.
5. Executed all office policies, facilitate billing and payroll procedures to maintain smooth and efficient office functions.
6. Responsible for interacting with physicians, staff and business office.
7. Maintained professional communications with patients regarding complaints.
8. Answered patients' billing questions while maintaining confidentially of all information related to patients, medical staff, finances, and cost-effective health care delivery issues.
9. Posted patient charges and generated files for submission by electronic or paper claims.
10. Collaborated with the collection agency to appropriately settle non-compliant delinquent accounts.

Experience

2-5 Years

Level

Junior

Education

Associate

Description :

1. Answered an average of 100 calls per day by addressing customer inquiries, solving problems and providing new product information.
2. Described product to customers and accurately explained details and care of merchandise.
3. Communicated with vendors regarding back order availability, future inventory and special orders.
4. Handled the daily heavy flow of paperwork and cooperated with the accounting departments on invoicing and shipping problems.
5. Received patient codes for equipment to use in assembling reimbursement claims.
6. Collected patient payments and audited charts and codes for applicable coverage.
7. Correctly coded and billed medical claims for various hospital and nursing facilities.
8. Meticulously identified and rectified inconsistencies, deficiencies, and discrepancies in medical documentation.
9. Payment from insurance companies, and following up on appeals and denied claims.

Experience

10+ Years

Level

Management

Education

Associate

Description :

1. Performed clinical and facility billing and UB-04.
2. Adjusted patients accounts, posted chargers, followed-up, printed statements, set-up payment on delinquent accounts.
3. Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
4. Reviewed documents such as purchase orders, sales tickets, charge slips, or hospital records to compute fees or charges due.
5. Performed bookkeeping work, including posting data or keeping other records concerning costs of goods or services or the shipment of goods.
6. Typed billing documents, shipped labels, credited memorandums, or credit forms, used typewriters or computers.
7. Computed credit terms, discounts, shipment charges, or rates for goods or services to complete billing documents.
8. Answered mail or telephone inquiries regarding rates, routing, or procedures.
9. Tasked with the responsibility of verifying patient's insurance coverage and eligibility for all insurance carriers and authorize coverage when verification has been completed.
10. Manage and process claims for 6 different programs and sites, throughout the Phoenix area.

Experience

10+ Years

Level

Senior

Education

Diploma

Description :

1. Checking each insurance payment is for accuracy and compliance with contract discount.
2. Calling insurance companies regarding any discrepancy in payments if necessary.
3. Responsible for managing accurate and timely completion and submission of all the billing, collections, and accounts receivable functions of the agency.
4. Submission of commercial insurance, MCO's, HOM's and patient/client billing.
5. Working directly with the insurance company, healthcare provider, and patient to get a claim processed and paid.
6. Reviewing patient bills for accuracy and completeness and obtain any missing information.
7. Patient orders, scheduling delivery tickets, and assist with the referral/intake process.
8. Communicating with office managers and staff at the clinics with any billing or patient account issues.
9. Providing tenacious follow-ups to ensure proper payments were fully collected.
10. Reviewing billing edits and provided insurance providers with corrected information.

Experience

10+ Years

Level

Senior

Education

Diploma