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Medical Billing Customer Service

Kingwood, Texas, 77339, United States
August 21, 2018

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Professional Summary

Talented Provider Services/Medical Billing/Coding specialist proficient in daily accounts receivable operations, collections and reporting. Open and clear communicator with a consistent approach to reviewing and improving processes. Adept at maximizing productivity and offering over a 20 year track record of success.


Medical coding (ICD 10)

Medical billing (CPT)

Medicare/Medicaid/Commercial Insurances


Team leadership

Skilled in MS Word/Excel and computers

Data Analysis/Management

Strong verbal communication

Interpersonal and written communication

Code Validation skills

Clerical support

Conflict resolution

Data entry

Work History

Provider Services/Clinical Administrator, senior 03/2010 to 06/2018

United HealthGroup (United Healthcare) – Houston, TX

Initial triage of members, administrative intake of members or managing the admission/discharge information Prior-authorization.

Working with hospitals and the clinical team, including managing incoming calls.

Managing requests for services from providers/members, providing information on available network services and transferring members as appropriate to clinical staff.

Manage the referrals process, process incoming and outgoing referrals, as well as prior authorizations, including intake, notification and census roles.

Performing multiple administrative tasks while concurrently triaging phone calls and triaging customer calls.

Timely response to customer and care team needs.

Proficient knowledge of ICD-10 and CPT

Provide excellent customer service to both providers and enrollees. Assist with faxes and emails.

Medical Billing Specialist

The Center for Orthopaedics & Sports Medicine 03/2006 to 02/2010

Medical Coding and billing.

Insurance verification.

Prior authorization.

Provided patient diagnoses under strict time constraints.

Performed account reconciliations and resolved variances.

Confirmed accurate completion of forms/reports for Medical billing and collections.

Coordinated with nursing staff to process and direct patients to the appropriate departments for surgery's and patient care.

Processed monthly reports for department performance.

Identified process improvements in the day-to-day functioning of the department.

Insurance appeals for claims and prior authorization.


High School Diploma/GED

Splendora High School – Splendora, TX

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