Insurance Custom Service

Poised and confident medical biller with a focus on accuracy and compliance. Seeking a position with a professional and established company where I can utilize my skills and knowledge as a medical biller. Eager to advance my skills and keep up with the fast paced changes of technology to ensure the most reliable way of medical billing. I work well in a team based environment as well as independently and thrive in a fast paced working environment.

Specialities

Bookkeeping/Accounts Receivable

Microsoft Word and Excel experience

Utilization of Medicare and commercial insurance company policies and NCCI Edits

Creating and maintaining Excel spread sheets

Types 45+ WPM

Month end reconciliation of payments and adjustments made

Paper and electronic appeals

Paper and on-line claim submission

Extensive customer service

Review of monthly aging reports

10 Key by touch

Professional Experience

Encompass Healthcare Billing- Lakewood, CO

Medical Biller/Accounts Receivable

October 2015- Present

Primarily responsible for posting all insurance and patients payments to all accounts

Determining if individual claims need to be appealed, corrected or if sufficient payment has been received according to provider agreements, adjusting accounts and billing patients appropriately. Also informs the appropriate account representative of the action needed to be taken regarding the payments/denials received.

Responsible for weekly deposits of checks received directly at the billing office. Notifying the providers of the deposit amounts via Excel spread sheet and creating files containing pertinent information regarding the deposits.

Responsible for 3 small non participating provider’s accounts. Responsible for requesting the billing codes (CPT and ICD-10). Inputs patient demographic information as well as charge information. Also submits electronic or paper claims by utilizing Optum Connectivity (ENS).

Follows up on all outstanding claims and patient balances 30 days and older from monthly aging reports and sending appeals, corrected claims and patient statements when deemed appropriate and necessary. As well as submitting any information to insurance companies to ensure timely and proper reimbursement of claims.

Communicates directly with the providers regarding any issues regarding claims, patient balances, billing protocol including Medicare and Medicaid regulations and any other issues that need resolving or questions answered.

Utilizing any resources available such as CMS, Medicare LCD and NCD policies. NCCI Edits table to ensure proper code/modifier submission on the initial claims to avoid any hold up in claims processing.

RPM Medical Billing- Greenwood Village, CO

Medical Biller/Accounts Receivable

January 2013-May 2014

Acts as a direct liaison between the doctor’s office and the insurance companies to ensure maximum reimbursement for services provided

Processes superbills from provider’s office for data entry for electronic claims submission to insurance companies and reviewing for correct coding and CPT/ICD-9 combinations as well as modifiers to ensure initial correct processing of claims

Revision of claims that reject for claim errors for electronic re-submission

Posting of payments from insurance companies and patients to appropriate accounts ensuring accuracy and balancing of monies posted to monies deposited

Follow up on claims to ensure timely processing of insurance claims

Appeals processes to further ensure payment of denied claims

Month end reconciliation of money posted to accounts to money deposited into the bank

Review of monthly aging reports to follow up on insurance/patient balances

Clinic Service Corporation- Denver, CO

Account Manager/ Accounts Receivable

January 2004- January 2013

Acts as a direct liaison between the doctor’s office and the insurance companies to ensure maximum reimbursement for services provided

Works directly with doctors office staff to ensure all correct demographic information is received before claim submission as well as to gather all other pertinent information

Processes superbills to ensure proper line diagnosing and modifiers are used for initial correct claim submission

Data entry of patient and insurance information

Works electronic rejects from the insurance companies to correct any coding errors or incorrect information sent to insurance companies

Works daily payments received by patients and insurance companies as well as deposits the money and posts to appropriate patient accounts

Records payments and adjustments in Excel spread sheet for end of month reconciliation

Works monthly aging reports, as well as weekly reports to ensure timely payment by insurance companies as well as patients. This includes calls to insurance companies as well as patients to collect outstanding balances

Utilization of insurance company websites to check claim status and patient eligibility

Submission of paper and electronic appeals or claim corrections

National Mortgage Company- Greenwood Village, CO

Receptionist

June 2003- January 2004

Answers multiple phone lines and directing potential clients to the appropriate customer service representative for application processing

Creates and maintains Excel spread sheets to keep track of data

Ships confidential information on a daily basis using UPS online

Basic office duties such as filing, copying, faxing and maintaining an organized office area

Extensive customer service

Education

High School Graduate, June 2002

Englewood High School, Englewood, CO

Excel

Medical Terminology

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