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Customer Service Medical Billing

Springfield, Massachusetts, United States
January 21, 2018

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Leslye Marshall

Best contact number and email: 413-***-**** alt. 413-***-**** / Skills/Qualifications:

Polished healthcare professional with over 13 years of experience including Hospital, Managed Care and Third- Party Medical Billing settings

Diverse experience with but to limited to DME, Short Term and Long Term Disability and Worker’s Comp claims

Well-versed in medical billing and coding, claims, insurance verification, reviewing payer payments and collecting outstanding balance, setting up payment plans, able to read face to face notes and maintaining medical records

Strong experience with Medicare claims processes and fully aware of Medicare claims 72 hour rule

Extensive knowledge of Medical Terminology, ICD9/ICD10, CPT, HCPC codes, HIPAA guidelines

Proficient with Meditech, Reams, PECOS system

Professional Experience:

06/2016 – 12/2017 Rotech Homecare Services Windsor, CT Hospital Billing/ Medicare Billing Specialist

Handled high volumes of incoming calls and made outbound calls for missing info

Averaged 50-60 per day giving exceptional customer service for each caller request

Billed to Medicare for hospital DME products

Called insurance to verify eligibility for patients hospital equipment

Verified face to face notes, prescriptions were signed dated with physician’s NPI and insurance primary and secondary

Took walk in patients for DME supplies entered into system new orders

Worked on backed log of order and staying current with new on daily basis 05/2015 – 05/2016 Meridian Medical Management Windsor, CT Physician Biller

Researched, resolved, and documented patient inbound and outbound calls involving a wide range of issues utilizing multiple information systems

Communicated with internal business centers and external customers

Assured customer agreement by summarizing and closing each call appropriately

Investigated payment status and determined ultimate patient financial responsibility

Escalated patient issues and concerns to the appropriate senior

Worked with internal and external customers to obtain appropriate medical documentation, work orders, proof of delivery, or other documentation necessary to resolve open account issues

Reviewed payer payment explanation for accuracy of patient responsibility

Collected outstanding balance, offered patient assistance with financial responsibility through various financial options

03/2009 – 11/2014 Innovation First Notice North America Springfield, MA Senior Customer Service Representative

Handled high volume of medical billing request and escalated calls

Managed insurance and medical call center claims with personal, commercial, Short Term and Long Term Disability and Worker’s Comp claims

Reviewed claims edits and revised coding/charged appropriate for specific CPT and HCPCS codes for processing clean claim submissions

Communicated with clients, insurance agents, attorney's repair shops and restoration specialist

Operated as team lead for new employee's

06/2008 – 01/2009 Cigna Bloomfield, CT

Eligibility Specialist

Handled high volume customer service and managed data entry with accuracy

Coded and enrolled new accounts for Medical, Dental, STD, LTD, Life and Worker's Compensation 01/2003 – 04/2008 GE Financial Assurance Agawam, MA Eligibility Analyst / Medical billing

Reviewed claim edits and revise coding/charging as appropriate for specific CPT/HCPCS codes

Reviewed claims returned from various departments due to edits and process corrections for clean claim submission or post claim denial review for appeal

Adhered to all department coding procedures, policies, and guidelines and quality standards

Completed on a daily basis cases that have been assigned to them utilizing the appropriate work lists Education:

High School Diploma

High School Of Commerce


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