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Medical Billing Customer Service

United States
April 30, 2014

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Randy Sprawling

Medical Office Specialist

**** ** **** ** **** APT#1509 - Houston, TX 77068 - 832-***-****

My objective is to obtain a position as a Medical Office Specialist in Medical Billing and Collections. My goal

is to perform efficiently as where my skills are an asset to the company and administer in-depth knowledge

of coding techniques and guidelines of medical coding. I am a graduate of The Texas School of Business

in Medical Office Management and have performed insurance verifications, billing and coding procedures for

multiple specialty groups and hospitals across the United States.


Medical Biller/ Denials and Appeals Specialist

UT Physicians- McKesson - Houston, TX - May 2013 to Present

My positions at UT- Physicians include Medical Billing, Patient Eligibility, Insurance Verifications, Claims

Follow-up, Head Secondary Appeals Coordinator, and Patient Registration, with specialty program knowledge

in systems such as EPIC, Care 4, IDX, All Scripts, Availity, TMHP online and numerous McKesson

administered programs.

• Private Ins./ Medicare and Medicaid Billing/ Appeals

• Patient Eligibility Verification

• Medical Records/ Document Management

• Payment Posting

• Medical Billing

Medical Claims Auditor

Alegis Revenue Solutions - The Woodlands, TX - August 2011 to March 2013

Accounts Receivable

My primary job duties included secondary insurance biller, electronic record keeping, and denials follow-up.

I have mastered denial procedures for pre- authorizations, insurance verifications, duplicate charges, non

covered charges, non- credentialed provider, invalid procedure and or diagnosis, and a list of other denials.

• Private Ins./ Medicare and Medicaid Billing

• Patient Eligibility Verification

• Inpatient/ Out Patient Claims Management

• Denials/ Appeals

Medical Office Specialist Temp to Hire Alegis Revenue Solutions

Acclivity Healthcare - Houston, TX - December 2010 to August 2011

Office Management

• Availity/ Electronic File Management Accessible

• Medical Billing

• Medical Coding

• Insurance Verification

• Patient Registration

Technical Support

Spherion Outsourcing - Houston, TX - March 2010 to August 2010

Customer Service

• Data Entry

• Tracking

• Inbound and Outbound Calling Procedure

• 10 Key

• Microsoft Word and Excel

Annual Benefits Coordinator

Hewitt Associates - The Woodlands, TX - September 2009 to December 2009

Medical, Dental, and Vision Insurance Enrollment

• Insurance Verifications

• PCP Referral Personel

• Commercial Insurance efficient

• HIPAA Certified

Medical Billing/ Coding Intern

Northwest Med Care P.A - Houston, TX - January 2009 to April 2009

Medical Billing/ Coding

• Office Transcription

• Electronic File Management/ Appointment Scheduling

• Patient Registration

• Claims Follow-up

Technical Support Representative

NCO Best Buy - Humble, TX - May 2006 to January 2009

• Technical Support/ Troubleshooting

• Customer Service

• Inbound/ Outbound Calling

• Sales

• Appointment Scheduling


Certificate in Medical Office Administration

Texas School of Business - Houston, TX

2008 to 2009

AAS (40 hours completed) in Business Administration

Houston Community College NE - Houston, TX

2005 to 2007

Aldine Senior High School - Houston, TX

May 2004


Medical Billing/Coding, Insurance Verifications, Denials/Appeals, for specialities such as Internal Medicine,

Radiology, Emergency Medicine, Anethesia, Neurology, Oncology, Family Practice



Skills and Abilities

State of Texas Certified "Medical Office Specialist"- 2009

Medical Records, Billing, Accounts Receivable, and Appeals done for hospitals such as Memorial Hermann

Hospital system, UT- Physicians, Methodist Hospital system, St. Lukes Episcopal Hospital system, and

Riverside Community Hospital, CA

• Commercial/Medicare and Medicaid Billing Procedures

• Inpatient/Out Patient Claims Specialist

• Electronic Records Management

• Medical Claim/ Eligibility Review

• Medical Claim Adjustor/ Accounts Receivable

• Medical Billing/ Medical Coding

• Appeals/ Denials

• Office Transcription

• HIPAA Certified

• ICD-9, ICD-10, HCPCS, UB-04, CMS 1500

• Medical Records Management

• Microsoft Office (Word, Excel, Powerpoint, Outlook)

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