Medical Billing

MELODY LIRATO

***** ******* ****., ******* ***., MI 48038

Cell #: 586-***-****, *******@*******.***

SUMMARY OF QUALIFICATIONS

Twenty years of medical administrative/billing experience with a strong focus on customer service/satisfaction

Successful track record in handling complicated assignments, reconciling insurance claims, processing insurance and patient payments, and resolving account disputes

Effective in investigating workers compensation and liability cases that often involve litigation

Proficient in a variety of practice management software applications, including EMR

Strong communication and interpersonal skills

Excellent work ethic and the ability to work well with others

PROFESSIONAL EXPERIENCE

Orchard Toxicology Laboratories – September 2015 to present

Medical Billing Liaison

Ensure all billing submitted to us by over 100 clients, is reviewed for accuracy before it is released to our outsourced billing company

Establishing and maintaining professional relationships with employees, clients, and billers

Identify problems, analyze them and resolve them as quickly as possible with no supervision

Continuously research new medical billing procedures and practices to keep up with this industry's changes

Utilize numerous resources to obtain accurate information necessary to submit clean claims, to reduce, or eliminate the number of denials, and ultimately increase revenue

Trinity Senior Living Communities – October 2014 – September 2015

Medical Billing Analyst

Submitted clean electronic claims for facility services for nursing homes in compliance with office practices and HIPPA regulations

Billed for room and board, therapy and ancillary services

Posted insurance payments, kept track of all money generated and reconciled monthly with the facility

Worked on aging reports by utilizing multiple secured websites and called to follow up on unpaid claims

Utilized E-Solutions, Networks, and Vision to track, correct and status claims

Advanced Medical Billing Services, Inc. – July 2002 – September 2015

Sr. Medical Biller

Was responsible for billing and submitting clean paper and electronic claims for professional services for hospital and office patients in compliance with office practices and HIPPA regulations. Insurances include, but were not limited to Medicare, BCBS of MI, Medicaid, Cofinity and HAP

Billed for homecare services and certifications

Billed claims for preventative services, including annual physical exams, pap smears/breast exam, counseling for obesity and smoking cessation to all insurance carriers

Billed for auto and worker’s compensation claims which included the submission of medical records upon request

Worked on aging reports for primary and secondary claims on a monthly basis

Retrieved Electronic Remittance Advice (ERA’s) from each individual insurance company website

Posted and reconciled insurance and patient payments within a timely manner

Researched and resolved incorrect payments, EOB rejections and other issues with outstanding accounts; that included the daily use of C-Snap, Web-denis, Navinet and many others

Answered and resolved patient account questions pertaining to their balances

Trained staff on the use of billing and scheduling software

Melody Lirato

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Miller Vein - October 2013 - December2013

Medical Technician

Greeted patients, took their vital signs and photos of body parts being treated

Assisted the RN in the removal of spider veins with the use of a cryo machine

Communicated with patients before and after procedures

Ensured all exam rooms were clean and instruments were sterile

Bloomfield Internal Medicine, Bloomfield Hills, MI - July 2002 to September 2013

Medical Receptionist/Biller

Greeted patients both in person and by phone

Obtained prior authorizations for testing and medications

Scanned into electronic medical records

Collected patient co-pays and outstanding balances

JD Power and Associates Troy, MI – January 2000 to July 2002

Automotive Research Analyst

Was responsible for conducting surveys to gauge customer satisfaction for various automotive suppliers

Communicated with vendors and obtained quotes for multiple projects

EDUCATION

Bachelor of Science in Marketing, Oakland University, Rochester, MI

KEY SKILLS

Excellent interpersonal, communication and problem solving skills

Strong working relationship with co-workers, superiors, teams and clients

Proficient in daily utilization of Medicare C-Snap, Medicaid Champps, BCBS Web-denis and commercial insurance websites

Medical insurance verification and eligibility via telephone and use of multiple web-sites

Ability to accurately obtain vital information to reduce the number of denied claims

Excellent in the use of ICD-10 coding, CPT, Microsoft Windows and Outlook

Experienced level of medical terminology and HIPPA Compliance

Various practice management software, including SoapWare, GloStream, Medisoft, Vision, E-Thomas

REFERENCES

Available upon request

Contact this candidate