Medical Billing Representative’s job description is to collect accounts, maintain invoice and generate revenue for the services rendered at the healthcare facility. Typical duties commonly seen on the Medical Billing Representative Resume include – balancing submitted claims on day to day basis, overseeing accruals, preparing invoice, reconciling billings with A/C’s receivables, billing audits, assessing unpaid claims, applying payments and adjustments, updating patient demographics, assessing and resolving denied claims, and maintaining financial records on third-party insurance, government and patient billing.
A good knowledge of laws governing medical billing and insurance claims, solid knowledge of medical terminologies, proficiency with billing software, staying updated with latest medical billing software and attention to detail are some of the common qualifications seen on successful resumes. Education requirements vary based on employer and industry preference, however, most of the employers want an Associate’s degree and prior billing and collection experience.
Objective : Diligent medical billing representative with two years of experience in managing claims processing, insurance verification, and patient account resolution. Proficient in navigating billing software and maintaining compliance with healthcare regulations. Committed to enhancing patient satisfaction through effective communication and problem-solving skills, ensuring accurate billing and efficient collections.
Skills : Medical Billing Software Proficiency, Data Analysis And Reporting, Claims Management, Insurance Verification Techniques
Description :
Facilitates the collection of overdue accounts by developing payment plans and following up with patients on payment statuses.
Collaborates with collection agencies and legal representatives to recover outstanding debts effectively.
Prepares and maintains Medicare bad-debt cost reports, ensuring accurate tracking of billings and collections.
Initiates probate claims by coordinating with legal departments on deceased patients' accounts.
Ensures compliance with hospital policies by adhering to established procedures and reporting discrepancies.
Maintains high-quality standards in billing processes to guarantee accuracy and confidentiality.
Trains new employees on billing practices and software usage to enhance departmental productivity.
Experience
0-2 Years
Level
Entry Level
Education
AAS
Assistant Medical Billing Representative Resume
Headline : Accomplished medical billing professional with 7 years of extensive experience in claims processing, insurance verification, and patient account management. Skilled in utilizing billing software, ensuring compliance with healthcare regulations, and enhancing revenue cycle efficiency. Adept at resolving billing issues, fostering patient satisfaction, and collaborating effectively with healthcare teams.
Complete billing forms and initiate transactions with third-party payers, ensuring timely payment cycles and follow-up on claims.
Manage patient entry and updates in Brightree, overseeing the transfer of medical records.
Post accounts receivables and address billing inquiries while responding to additional information requests from health plans.
Conduct claims and benefit research, ensuring accurate customer information entry.
Verify insurance coverage, applying knowledge of CPT and ICD-10 coding.
Assist with phone inquiries, providing efficient support and redirecting calls as necessary.
Collaborate closely with the Rehab Department to manage billing approvals and send prior authorization requests.
Experience
5-7 Years
Level
Executive
Education
AAS
Medical Billing Representative Resume
Objective : Results-oriented medical billing representative with two years of experience in claims processing and patient account management. Expertise in insurance verification, compliance with healthcare regulations, and efficient billing practices. Passionate about optimizing revenue cycles and enhancing patient experiences through clear communication and meticulous problem-solving.
Skills : Research Skills, Claims Processing Software, Regulatory Knowledge, Billing Disputes, Team Collaboration, Multi-tasking
Description :
Prepared and attached all required claims documentation, including referrals and treatment plans, to minimize denial rates.
Executed insurance verification and pre-certification functions efficiently, enhancing workflow.
Managed full-cycle medical billing in a high-volume environment, ensuring timely claim submissions.
Maintained up-to-date knowledge of insurance requirements, including patient financial responsibilities.
Submitted refund requests for claims processed in error, recovering lost revenue.
Completed appeals and filed claims promptly, ensuring adherence to guidelines.
Analyzed remittance codes from EOBs to identify and rectify billing discrepancies.
Experience
0-2 Years
Level
Entry Level
Education
AAS
Senior Medical Billing Representative Resume
Headline : Skilled Senior Medical Billing Representative with 7 years of comprehensive experience in claims management, insurance verification, and patient account oversight. Expert in optimizing billing processes and ensuring compliance with healthcare regulations. Committed to enhancing revenue cycle performance and resolving complex billing issues to support exceptional patient care.
Skills : Microsoft Office Suite, Excel Data Analysis, Powerpoint Presentations, Healthcare Compliance Research, Healthcare Revenue Cycle Management, Negotiation And Persuasion
Description :
Managed patient account information, including insurance details and medical claims processing.
Processed billing statements and reimbursement claims, ensuring accuracy and compliance.
Conducted follow-ups with insurance providers on unpaid claims, initiating appeals when necessary.
Thoroughly analyzed patient accounts to ensure data integrity and compliance with contracts.
Developed training materials to enhance staff proficiency in billing practices.
Identified and corrected aged claims, enhancing revenue recovery by 40%.
Resolved discrepancies in payment and claims, maintaining a high level of customer satisfaction.
Experience
5-7 Years
Level
Senior
Education
AAS
Medical Billing Representative Resume
Objective : Dedicated medical billing representative with 5 years of experience in claims processing and patient account management. Expertise in insurance verification and proficient in industry-standard billing software. Focused on optimizing revenue cycles and ensuring compliance with healthcare regulations, while enhancing patient satisfaction through effective communication and problem resolution.
Managed patient data entry and maintained comprehensive medical records for billing accuracy.
Reviewed and validated medical records to ensure compliance with insurance requirements.
Conducted audits of diagnosis codes for precision and appropriateness based on services rendered.
Processed and entered procedure and diagnosis codes into billing software with high accuracy.
Collaborated with healthcare providers to resolve billing discrepancies and inquiries.
Responded promptly to client inquiries regarding billing and coding issues.
Acted as a liaison between healthcare teams and insurance payers to facilitate smooth billing operations.
Experience
2-5 Years
Level
Management
Education
AAS in Medical Billing
Lead Medical Billing Representative Resume
Headline : Seasoned medical billing expert with 7 years of specialization in claims management, patient account reconciliation, and insurance verification. Adept at optimizing billing processes, ensuring regulatory compliance, and enhancing revenue cycle efficiency. Passionate about delivering exceptional patient service and resolving complex billing disputes to support healthcare operations.
Skills : Workflow Management, Financial Record Management, Icd-10 And Cpt Coding, Patient Relations And Support
Description :
Supervise billing team performance, ensuring compliance with policies and procedures.
Provide mentorship and training to staff, fostering professional development and goal achievement.
Analyze workflow and implement improvements to enhance operational efficiency.
Launch initiatives to boost team morale and engagement, such as employee recognition programs.
Conduct thorough reviews of billing edits and communicate necessary corrections to insurance providers.
Evaluate team productivity metrics and provide actionable insights for improvement.
Collaborate with cross-functional teams to resolve billing discrepancies and enhance patient satisfaction.
Experience
5-7 Years
Level
Management
Education
B.S. in HCA
Medical Billing Representative Resume
Headline : With 7 years of experience in medical billing, I excel in claims processing, insurance verification, and patient account management. My expertise in revenue cycle optimization and compliance with healthcare regulations ensures accurate billing. I am dedicated to enhancing patient experiences through effective communication and resolving billing discrepancies efficiently.
Skills : Accounts Receivable, Attention To Detail, Effective Patient Communication, Insurance Claims Resolution, Medical Coding, Insurance Verification
Description :
Enter and verify patient demographics and insurance information in the billing system.
Sort and log medical bills for coding processes, ensuring accuracy and compliance.
Research and resolve insurance inquiries when information is incomplete.
Process billing for specimen procedures, entering relevant CPT codes accurately.
Communicate with patients regarding their accounts and billing inquiries.
Make outbound calls to gather missing information from providers and insurers.
Maintain documentation and records in accordance with HIPAA regulations.
Experience
5-7 Years
Level
Senior
Education
AAS
Junior Medical Billing Representative Resume
Objective : Detail-oriented Medical Billing Representative with over 5 years of experience in processing claims, managing patient accounts, and ensuring compliance with healthcare regulations. Proficient in various billing software and adept at resolving discrepancies to optimize revenue cycle management. Strong communication skills and a commitment to providing exceptional service to patients and healthcare providers.
Skills : Adaptability, Technical Skills, Documentation Skills, Quality Assurance, Process Improvement, Ehr Systems
Description :
Prepare and submit accurate claims to various insurance companies, both electronically and via paper.
Utilize medical terminology, CPT codes, ICD-10, UB-04, and HCFA-1500 for precise billing.
Verify insurance guidelines, particularly for Medicare and state Medicaid, while addressing inquiries from patients and insurance companies.
Review patient bills for accuracy, completeness, and resolve discrepancies promptly.
Follow up on unpaid claims within the standard billing cycle to ensure timely payments.
Ensure compliance with contractual agreements by checking the accuracy of insurance payments.
Contact insurance companies to address discrepancies and secure payment resolutions.
Experience
2-5 Years
Level
Junior
Education
AAS
Medical Billing Representative Resume
Objective : Proficient Medical Billing Representative with two years of experience in claims processing and insurance verification. Skilled at ensuring accurate billing and resolving patient accounts while adhering to healthcare compliance standards. Eager to leverage strong communication and analytical skills to enhance billing efficiency and patient satisfaction.
Skills : Problem Solving, Communication Skills, Medicare Billing, Claims Processing, Patient Billing, Payment Posting
Description :
Enhanced revenue collection by improving claim submission accuracy and reducing denial rates.
Orchestrated collections totaling $2 million from past denied claims within one year.
Managed billing department operations, ensuring timely submission of claims within 24 hours.
Applied payments accurately to patient accounts, maintaining up-to-date records.
Posted and reconciled insurance and patient payments efficiently.
Investigated and resolved discrepancies in payments, EOB rejections, and outstanding accounts.
Reviewed insurance claims for accuracy, verifying correct coding for various specialties.
Experience
0-2 Years
Level
Entry Level
Education
AAS
Associate Medical Billing Representative Resume
Headline : Dynamic medical billing professional with 7 years of expertise in claims processing, insurance verification, and patient account management. Proven ability to enhance revenue cycle operations and ensure compliance with healthcare regulations. Passionate about resolving billing discrepancies and improving patient satisfaction through effective communication and meticulous attention to detail.
Focused efforts on increasing cash flow and minimizing bad debt through effective claims management.
Applied payments and addressed denials from third-party carriers, interpreting Explanation of Benefits for appropriate follow-up.
Processed refunds and adjustments to customer accounts, maintaining accuracy with necessary documentation.
Conducted follow-ups with third-party carriers to resolve denied claims efficiently.
Analyzed and applied denial codes, optimizing claims processing for quicker resolution.
Evaluated and responded to billing inquiries from patients and representatives, ensuring timely resolution of issues.
Maintained contact with insurance carriers, clients, and patients to facilitate smooth billing operations.
Experience
5-7 Years
Level
Executive
Education
AAS
Medical Billing Representative Resume
Headline : Dedicated Medical Billing Representative with a proven track record in accurately processing medical claims and managing billing inquiries. Skilled in utilizing electronic health record systems and billing software to streamline operations. Excellent problem-solving abilities and a strong understanding of insurance policies, ensuring timely reimbursements and patient satisfaction.
Skills : Healthcare Administration, Electronic Medical Record Management, Medical Coding And Transcription, Medicaid Billing, Third-party Billing
Description :
Implemented effective collections strategies to recover outstanding payments on delinquent accounts.
Conducted thorough follow-ups and documentation on overdue accounts to secure payments.
Verified insurance coverage and benefits for patients across multiple insurance providers.
Performed detailed accounts reconciliation to maintain accurate financial records.
Managed correspondence with patients and insurance carriers to resolve billing inquiries.
Analyzed and addressed denied claims with insurance companies to facilitate payment resolution.
Accurately posted payments, charge entries, and adjustments in daily financial reports.
Experience
5-7 Years
Level
Senior
Education
AAS
Medical Billing Representative Resume
Objective : Enthusiastic Medical Billing Representative with two years of experience specializing in claims submission, insurance verification, and patient account management. Adept at utilizing billing software to ensure compliance with regulations and streamline processes. Driven to deliver exceptional service and improve billing accuracy, contributing to enhanced patient satisfaction and efficient revenue cycle management.
Skills : Icd-10 Coding, Training And Mentoring, Hcpcs Coding, Confidentiality, Critical Thinking
Description :
Prepare and manage billing for accounts to guarantee timely reimbursements.
Ensure all claims are submitted within 48 hours of print date to maintain workflow efficiency.
Review and correct edit reports for electronically submitted claims to minimize errors.
Identify and verify insurance requirements to meet payer specifications.
Audit bills for accuracy in products, codes, and physician information before submission.
Respond to written inquiries from customers regarding account status within five days.
Address verbal patient inquiries within 24 hours to enhance service quality.
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