Sunday, September 23, 2012

Sample Medical Biller Resume

Objective:
To obtain a challenging position that would utilize my experiences and educational training.


Experience:
March 2012- Present
OhioHealth
A/R Specialist

Responsible for ensuring unpaid and partially paid claims are resolved in an efficient and timely manner.
Resolves EOBs/ ERAs discrepancies and researches refunds.
Follows up on submitted claims, monitor unpaid claims and resubmits claims with appropriate corrections and documentation.
Works declines and processes appeals.
Responds to patient and third party inquiries; researches and resolves simple to moderately complex issues; corrects errors and refers complex issues to supervisor.
Reviews correspondence and rejection data from insurance carriers; posts rejections and performs reconciliations.
Transfer secondary balances to appropriate financial class and provides documentation for processing the claims.
Reviews Credit Letter Sent (CLS) and transfers balance to appropriate financial class and dunning level.
Reviews, works and clears electronic and claims edits daily; summarizes and forwards non-workable edits to supervisor for resolution.
Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment
Follows up on unpaid/unresolved account balances on a daily basis and notates follow up response on patient accounts
Completes re-bill request as necessary to facilitate timely and proper claims payment
Provides insurance carriers with requested information to facilitate payment
Prepares adjustment and write-off requests as necessary and timely

August 2008- March 2012
Progressive Medical Inc
Home Healthcare / Infusion Medicine Billing Specialist


Prepares and process customer BWC invoices by reviewing and gathering account documentation
Calculate home care fees and infusion medicine charges.
Enter vendor invoices and statement into Oracle system.
Review patients BWC quotes that are called in by adjuster
Calculating and enter billing amount base off the BWC regulation guidelines, Medicare fee schedule and the patients SOJ.
Research, resolve and correct vendors and BWC provider issues basis from incorrect invoices, statements, HCFAs, UB92s and quotes.
Verify transaction data that was enter into the system by balancing and correcting daily billing reports.
Work EOBs and EORs
Works and resolves system edits.
Prints and reviews invoices for mailing.
Work denials and short paid EOBs and EORs received from BWC insurance company while following the BWC State guidelines and regulations.
Post the insurance payment amount to the patients account once received from BWC insurance companies
Credit any over paid accounts back to insurance companies.
Resolve any issues with vendor about short pay or denied EOBs and EORs.
Sets up and maintains department files.
Keep track of BWC code changes per state.
Stay current with BWC state guideline changes and updates.

October 2006 – August 2008
Franklinton Career & Technology Center
Medical Billing and Coding Instructor Assistant
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Maintain a teaching assignment for each module.
Plan course instruction based upon approved syllabus/outline provided, to assure course content and objectives are met. 
Instruct the assigned course(s) in accordance with the approved curriculum.
Design, administer and grade examinations to assess achievement of course objectives as identified in the syllabus.
Be available to advise students, tutor and provide other assistance as needed. Maintain a daily record of student attendance and grades in accordance with school policy.
Instruct student on CPT, ICD-9, medical Insurance, medical terminology and anatomy within the course.
Educate medical billing & coding students in the classroom setting and in the lab.
Prepare lectures and present material to students and demonstrate billing/coding skills, as well as provide knowledge gained from experience in working in the field.
Responsible for lesson plans and classroom management.

November 1997- September 2008
Various Long-Term Contracting Companies
Patient Representative, Benefit Claims Rep Medical Billing Rep, HME/DME Billing


Responsible for compiling amounts owed to medical facility.
Reviews and maintains orders, invoices records to ensure accuracy. Maintains all patient payment records.
Organizes and evaluates patient medical records.
Reviews medical records for accuracy and completeness.
Organizes in-patient and outpatient claims for electronic or hard copy mail and forwards to appropriate third party payers.
Reviews claims to make sure that payer specific billing requirements are met, follows-up on billing, determines and applies appropriate adjustments, answers inquiries, and updates accounts as necessary.
Worked rejected claims ensuring that account are paid.
Perform billing procedures for surgical center, family practice, HME/DME providers and, ob-gyn practice.
Acts as a liaison between patients, patients' relatives, and the healthcare organization; communicates patients' questions, complaints, problems and concerns to appropriate staff members.
Ensures patients have been cleared for specialty service office visits. Resolves pre-certification, registration and case-related concerns prior to a patient's appointment.
Gathers pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient is not financially obligated for services provided.


Education:
University of Toledo
Toledo, Ohio
Computer Programming and Software 


Skills:
Microsoft Office
Microsoft Excel
Microsoft Word
Microsoft PowerPoint
Microsoft Publisher
Microsoft Access
Data Entry 10,000 kpm
CPT & ICD-9 Experience
Typing Speed 45 wpm
10 Key Calculator
Medical Terminology 


Additional Information:
Orcale
Mysis
Tims
Medical Manager
Scripwise
HES {Healthy Editing System}
Emdeon
Navinet
Epremis
QMS
Formfast
Star (Hospital Billing System )
Epic
Claimlogic 



Provided by: OneBuckResume

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