Customer Service Medical Billing

Abby Letellier

Email: ********@*****************.***

Address:

City: Minneapolis

State: MN

Zip: 55412

Country: USA

Phone: 612-***-****

Skill Level: Any

Salary Range:

Primary Skills/Experience:

Medical Billing and Collections specializing in Pharmacy and DME claims. Expertise includes verifying insurance coverage, prior authorizations and complex claims processing.

Educational Background:

High School Dipolma from Culver City Adult School, Culver City CA 1/2001 to 1/2009 (high school diploma)

Job History / Details:

Professional Summary

Medical Billing and Collections specializing in Pharmacy and DME claims. Expertise includes verifying insurance coverage, prior authorizations and complex claims processing.

Skill Highlights

Maintains strict confidentiality

Knowledge of HMOs, Medicare and Medi-Cal, Commercial, BCBS and Workers Compensation

Managed care contract knowledge

CPT and HCPCS coding

HIPAA compliance

Team player with positive attitude

Good written communication

Strong work ethic

Deadline-driven

Verifications and Adjustments

Patient billing and Collections

Medical Terminology

Payment Posting

CMS-1500 and UB-04 Claim Forms

ICD-9 coding

Internal medicine billing

Patient-focused care

Team player with positive attitude

Exercises good judgment

Professional Experience

April 2012 to November 2012

Modern Health/Express Pharmacy Monrovia, California

Workers Compensation Collector

Collected on Workers Comp bills and liens

Filed liens, sent out 10607 and 10608 letters, Filed DOR's

Negotiated files with Adjusters and Defense Attorneys

Sent bills and Demands to get paid on outstanding balances

Worked with programs Eams and Edex

Large A/R, Heavy Phones and Data Entry

December 2008 to April 2012

Medtronic/Minimed Northridge, California

Billing and Collection Specialist

Maintained, monitored and processed collection correspondence, documented in detail all phone calls, demand letters and other correspondence made in effort to collect on balances

Answered calls with respect to billing errors and issues

Initiated refund requests which include complex claim processing, contracts, policies and remittances

Researched and resolved all complex claims processing and written inquiries in regards to claims processing for all payers, Medicare, Medicaid, BCBS and Commercial Insurance's

Assisted lower level collection reps with resolution of complex or escalated issues

Assisted on special projects, Maintained excellent quality scores and production goals

Verified eligibility and benefits

Mailed out claim forms for billing issues or no claim on file

May 2006 to September 2008

Bioscrip Pharmacy Eden Prairie, Minnesota

Billing and Collection Specialist

Responsibilities included billing and follow-up for commercial insurances, BCBS, Medicare and Medicaid plans on outstanding balances, denials, prior authorizations and medical necessity

Worked with patients to resolve insurance billing issues

Created spreadsheets on Excel to provide cash posting with back up for payments

Trained new and existing staff on systems and their daily work routines

Managed three specialty pharmacies with 4.5 million in annual revenue

Worked with pharmacy staff to resolve electronic billing issues and rejected claims

Verified insurance with an expert knowledge of medical and pharmacy benefits

February 2005 to April 2006

State Farm Crystal, Minnesota

Insurance Rep/Customer Service

Answered incoming sales and service calls

Resolved issues, provided quotes and wrote business or directed to the appropriate person

Made entries into bank account and reconciled monthly bank statement using Quicken

Collected on past due accounts

Interfaced with a variety of clients and provided first class service on a individual basis

Kept track of inventory and reordered as needed

September 2001 to February 2005

Thrifty White Drug Maple Grove, Minnesota

Accounts Receivable/Collection Specialist

Processed all billing and collections for 13 pharmacies across three states

Worked Excel spreadsheets to collect on past due patient and insurance accounts

Billed Nursing homes for medical sheets using Excel spreadsheets

Answered incoming calls from patients and pharmacies to resolve any billing issues

Education and Training

2009 Culver City Adult School Culver City, California

GED

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