A Suspended Billing Representative makes prepares and handles billing for the customer/patient accounts. Essential duties and responsibilities are highlighted on the Suspended Billing Representative Resume as – preparing and handling billing for accounts to ensure timely reimbursement, ensuring that all paper claims are submitted with the timeframe, reviewing bills for correct products, correct codes, and correct billing, pulling patient files for verifying, ensuring that all required backup documentation is submitted with the bill, reviewing and correcting edit reports for claims submitted electronically, responding to written customer inquiries, responding to patient inquiries, and documenting all account activity on systems.
Minimum required qualifications include the following – knowledge of billing processes and procedures, attention to details, sharpness and attention to details, the ability to keep track of customer account periodically, and knowledge of using relevant software. Eligible resumes highlight a degree in fields such as accounting or finance.
Summary : Suspended Billing Representative professional with over 15 years of experience with the desire to become a team member of a positive, encouraging, fast moving business where I will be able to use my knowledge I have gained through education and experiences. I want to work with a company that I can continue to learn on a daily basis and be able to further my growth on a personal and professional basis.
Skills : Customer Service, Warehouse.
Description :
Started the company in the collections department.
Worked with insurance companies and patients to resolve billing issues.
Moved to the suspended billing department where I was responsible for getting information that was required to meet payor guidelines.
Completed non- government Rx's to obtain Dr's signatures and correct completion of information required by each payor.
Chosen to be trained on Medicare suspended billing and qualifications to be a part of the Medicare team.
Worked with Dr's offices and patients to get all qualifying information for Rx's and CMN's.
Make sure we have obtained all paper trails and correct information from the Dr. to meet compliance and get reimbursement from Medicare.
Experience
10+ Years
Level
Senior
Education
MS
Suspended Billing Representative Resume
Summary : Seeking a Suspended Billing Representative position with an outstanding career opportunity that will offer a rewarding work environment along with a winning team that will fully utilize management skills.
Skills : ICD-9 CM and PCS, ICD-10 CM and PCS, CPT, HCPCS, Microsoft Office.
Description :
Performed follow-up on outstanding Certificates of Medical Necessity (CMNs), prescriptions and processes renewal CMNs/prescriptions through the use of suspended billing reports.
Maintained and monitored follow up system to confirm that action takes place per Apria best practices.
Performed timely follow-up on renewal authorizations to maintain reimbursement activity.
Contacted patient to gain involvement in problematic situations.
Elevated aged prescriptions to manager for decision and resolution.
Evaluated all completed CMNs/prescriptions/authorizations to ensure that the appropriate information has been obtained to allow for reimbursement as well as compliance with applicable standards and regulations.
Entered CMNs/prescription information into computer once the prescriptions are completed and returned from the physicians.
Experience
10+ Years
Level
Senior
Education
GED
Suspended Billing Representative Resume
Headline : To obtain a position where I can utilize my experience in an office environment, my ability to adapt and learn quickly, and my ability to work well with others. I am a creative problem solver, planner, hard worker and punctual. I strongly believe in excellence in communicating; both written and spoken as well as cooperation with others is the key to a successful work environment.
Skills : Microsoft Office Suite, Project Management, Data Analysis, Record Keeping, Strategic Planning, Presentations, Staff Training.
Description :
Processed, reviews and mails prescription and/or CMNs to physicians for signature.
Documented all account activity on system.
Tasked to make sure the right documents were filed under the proper patient ID, in the correct state, in the correct order, and correct subfolder.
Upon reviewed of these documents I would reject the documents for correction if they did not comply with proper HIPPA and US government guidelines.
Verified compliant diagnosis and HCPCS codes to ensure payment from Medicare, Medicaid, and private insurance.
Actively worked suspended billing reports in order to reduce the outstanding claims.
Maintained contact with doctors and patients in order to secure the needed information to compete paperwork.
Experience
5-7 Years
Level
Executive
Education
Masters Of Business Administration
Suspended Billing Representative Resume
Objective : The goal is to obtain a full or part-time clinical position using my education and experience as an RRT to serve patients in the hospital setting in South Florida. I prepared and ready to relocate from Ohio to Florida at a moment's notice, as I have been planning this move for about a year.
Skills : Microsoft Office, Planning Skills.
Description :
Took calls from patients, doctors, nurses, other teammates, and insurance companies to find a resolution to difficult problems or questions concerning all of the company products.
Researched patient information including but not limited to diagnostic and titration sleep studies, deeming the chart notes and prescriptions compliant/non compliant for Medicare coverage.
Contacted physicians, sleep labs, and patients by phone, fax, and mail when necessary to obtain additional documentation.
Reviewed the patient charts and prescriptions, deeming compliant/non compliant for Medicare coverage.
Contacted physicians, hospitals, or patients by phone, fax, and mail if necessary to obtain additional documentation.
Used a complex electronic fax database to review, receive, and transfer faxes, prescriptions, chart notes, etc.
Documented from all of the company locations nationwide were received into this one database.
Experience
2-5 Years
Level
Executive
Education
A.A.S. In Respiratory Care
Suspended Billing Representative Resume
Objective : To obtain a Suspended Billing Representative position with a well-established company that will encourage the utilization of my advanced healthcare experience and healthcare educational background, strong organizational skills, and ability to work well with people on many different levels.
Skills : Windows 7, Windows Vista.
Description :
May performed internal quality audits to ensure that all necessary documentation is included in each patient file.
Processed, reviewed and mailed prescription and/or CMNs to physicians for signature.
Researched diagnosis and insurance benefits to receive proper reimbursement.
Obtained necessary documentation from Dr's/hospitals to obtain authorizations, CMN and Prescriptions.
Obtained copies of assigned Department logs daily.
Identified and mark log /track sheets of hospital admittance, outpatient services, and direct admits; submit billing information, count records to ensure reconciliation with the Emergency Dept. log and submit trauma patient billing.
Answered phone calls and handle inquiries.
Experience
2-5 Years
Level
Executive
Education
Bachelor Of Science
Suspended Billing Representative Resume
Summary : Organized Suspended Billing Representative with a foundation in records management. Experienced in billing and collection procedures. Ability to readily adapt to changing environments. Strong attention to detail, professional telephone etiquette, and organization skills. Certified Medical Billing Specialist with ten+ years of experience in a fast-paced, multiple client medical billing company.
Worked with insurance companies to obtain authorizations for patients medical equipment.
Worked closely with the patients and doctors offices to get documentation and information need for the patients insurance.
Chosen as one of a select few to go to India to help train our call center on how to work as a suspended billing representative.
Assisted with training our new reps in our Jackson office.
Experienced In working with all Microsoft programs such as Excell, Word and Power Point.
Assisted with training new employees.
Acquired authorizations for DME equipment rental/purchase.
Experience
7-10 Years
Level
Management
Education
BA In Business Management
Suspended Billing Representative Resume
Headline : Highly qualified Suspended Billing Representative with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and I would excel in the collaborative environment on which your company prides itself.
Skills : 89 Wpm, Office And Administration, Able To Operate All Office Equipment Efficiently, Excellent Customer Service/people, Professional, Self Motivated, And Dependable.
Description :
Evaluated all completed prescriptions/authorizations to ensure that the appropriate information has been obtained to allow for reimbursement as well as compliance with applicable standards and regulations.
Entered prescription information into computer once the prescriptions are completed and returned from the physicians.
Requested adjustments on accounts and recommends necessary changes to supervisor.
Performed billing investigations for home respiratory care company through the use of suspended billing reports.
Collected previous day’s patient charts, sorting in date and time order.
Reconciled missing or suspended list with required lag time.
Collected critical care charges of procedures, such as procedures performed in ICU/hospital and obtains/pulls charts, demographics, and insurance information.
Experience
5-7 Years
Level
Executive
Education
GED
Suspended Billing Representative Resume
Summary : To secure employment in a Suspended Billing Representative position that will utilize my skills and promote new growth with a company that I can excel in.
Skills : Microsoft Office, Supervising Skills, Billing Skills.
Description :
Researched any overdue account balance that is fully or partially unpaid and follows up by mail and/or phone to insurance carriers or customers on delinquent payments.
Reviewed claims denied for payment and underpaid claims.
Verified payment information adjustments to supervisor.
Coordinated collection activities for delinquent accounts by preparing information for external collection agencies or attorneys.
Responded to customer inquiries regarding account status.
Researched customers' accounts thoroughly and documents appropriately.
Resolved discrepancies and prepared adjustments and refunds as necessary.
Experience
10+ Years
Level
Senior
Education
High School Diploma
Suspended Billing Representative Resume
Headline : As a Suspended Billing Representative, responsible for Responding to inquiries from patients, patients families, departmental staff, insurance representatives, and third party payers in writing or by telephone.
Skills : Billing Skills, Operational Skills.
Description :
Ensured that all information regarding collection activity of account.
Maintained copy of billing information.
Adhered to Information Security Policies and ensure that Envision is as secure as possible.
Maintained timely reimbursement activity by staying current on renewal authorization information.
Worked on authorizations for approvals for equipment.
Prepared printed prescriptions to be sent to the ordering physician for signature.
Handled billing questions and filling prescriptions for patients - Updated patient accounts.
Experience
5-7 Years
Level
Executive
Education
GED
Suspended Billing Representative Resume
Objective : A dedicated, flexible, and organized employee seeking a Suspended Billing Representative position where I can prove my abilities and contribute to the growth of the company.
Skills : Computer, Customer Service, Insurance Verification, Excel And Powerpoint.
Description :
Corrected claims that were rejected; sent supporting documentation, re-coded claims using the proper ICD-9 and CPT diagnosis codes, and verified insurance coverage.
Performed follow-up on outstanding Certificates of Medical Necessity (CMN) and prescriptions, and processed renewals using suspended billing reports.
Contacted patient to resolve problematic situations.
Evaluated documents and reports to ensure appropriate information had been obtained.
Documented all account activity in computer system.
Complied with regulatory compliance areas, policies and procedures.
Assisted in obtaining authorization for reimbursement for some accounts.
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