Credentialing/Billing Specialist
Resume:
BEVERLY A HOLCOMB
Scottsboro, AL 35769
********@***.***
Objective
In recent years, I have been a stay at home mom with my toddler boy. I am ready to
get back out in the work force! Currently seeking a position in the credentialing/billing/insurance field in a professional
company. I have the skill set and knowledge involved in all areas of the billing department. Along with being organized and detail oriented, I have excellent problem solving skills and time management skills. This area is one that I am confident in and am seeking a full-time position for the right employer.
Education
KDS DAR High School, Grant, AL
Graduated May 2003
An A average with a specialization in college prep. Achievements: Freshman class vice president, sophomore class vice president, and junior class vice president, Student Director for DAR show choir, National Honor Society, and Peoples State Bank Junior Board of Directors.
Experience
May 2012- September 2013
Bigelow Family Dentistry
1202 South Broad Street, Scottsboro, AL 35768 Phone- 256-***-****
Position: Financial Coordinator
Duties consisted of maintaining doctors credentials with insurance companies,
ensuring dental licenses, controlled substance licenses, and DEA licenses were up to date, ensuring state/ county/ city license for business were up to date, sending insurance claims, verifying insurance for all patients, maintaining insurance and
patient accounts receivable, sending daily and monthly statements, reconciling credit card and Care Credit merchant statements, depositing checks directly into bank via Deposit Now software, audit end of day to ensure balancing, review and edit
employee timecards as needed, process payroll biweekly via Benefit Mall, order office supplies for front office and clinical staff, open and distribute mail, maintain and file invoices, give open invoices to doctor to pay, post all insurance and patient payments into OpenDental software, update OpenDental software as needed, maintain security settings for all employees within OpenDental, maintain insurance fee schedule, and ensure that all yearly coding additions and requirements are uploaded into system
and that staff are trained on new codes. I also maintained employee files and ensured that everyone was up to date on all Osha/ Hipaa requirements, hygiene licenses, as
well as ACLS certifications. I also installed any new equipment that needed to be
done.
May 2009- April 2011
The Heart Center
930 Franklin Street, Huntsville, AL 35801 Phone- 256-***-****
Worked in three different positions while at The Heart Center. Started in Cash Apps department and eventually ended up in the credentialing department. Below is listed the duties for each department.
Position: Cash Applications Specialist.
Duties consisted of processing mail, preparing and taking deposit to the bank, posting insurance payments and adjustments, making sure all audit journals balance, logging totals on spreadsheets, calling insurance companies regarding questionable EOB's, scanning EOB's into system, and filing posted EOB's accordingly.
Position: Medicare and BCBS Insurance Representative.
Duties consisted of working daily in Medicare and BCBS denial queues, edit lists, and E-commerce queues to insure that all claims are paid correctly and timely. Also
consisted of filing appeals with Medicare, Medicare HMO, and BCBS policies and updating patient insurance information.
Position: Credentialing Specialist
Duties consisted of sending out provider insurance applications, maintaining credentialing system, Symed (OneApp), maintaining all medical licenses etc for
all of the physicians, maintaining spreadsheets with all of the physician’s insurance provider numbers and effective dates, and completing any other paperwork necessary to ensure that the providers were contracted with all of the participating networks and would get reimbursed for services rendered.
September 2005- April 2007 and November 2007-September 2008
Tennessee Oncology, Nashville, TN
300 20th Avenue North, Ste 301, Nashville, TN 37203
Position: Patient Services Representative (09/05 thru 10/06)
Duties consisted of answering multiple phone lines, checking in high volume of
patients, verifying insurance, obtaining pre-patient registration information and insurance information for new patients, scheduling various appointments, taking
charts to laboratory, pulling charts for messages, collecting copays, completing daily
cash sheet, and various other office duties.
Position: Medical Records (10/06 thru 04/07)
Duties consisted of preparing patients charts in advance for appointments, pulling all filing for charts, pulling charts for phone messages, filing charts, and copying medical records for disability, insurance, or other doctor's offices.
Position: Clerical Support Clerk/ Insurance Processor. (11/07 thru 09/08)
Duties consisted of but were not limited to: claim scrubbing, claim spooling,
attaching primary and secondary EOB's to HCFA's as necessary, mailing out
insurance claims, maintaining E-commerce log to ensure that all electronic claims
have bent sent/received successfully, scanning all received EOB's into Groupcast/
IDX system, searching for and correcting any missing EOB's within IDX system,
sorting and delivering mail, logging received cash sheets, logging EFT's, daily
deposits, running credit card payments, sorting and logging all lockboxes received
from the bank, and any other duties assigned by the Cash Applications Manager.
March 2002- September 2005
Dr. Julian F. Sparks Dental Office
PO Box 69 Grant, Al. 256-***-****
Position: Office Assistant.
Duties consisted of maintaining patient records, scheduling appointments, and billing, filing primary and secondary insurances, monthly statements, bookkeeping, and various other office duties.
*References Available on Request*
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