SHANAY DARLING

Goodlettsville, TN ***** 615-***-**** ad1o8c@r.postjobfree.com

Professional Summary

Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment. Skills

Applicant Counseling

Web Portals

Account Management

Diagnostic Evaluation

Critical Thinking

System Updates

Data Analysis

Revenue codes and HCPCS codes

Patient Care

Patient Account Reviews

Time Management

Patient account analysis

Medical coding knowledge

Medical terminology expert

Work History

Insurance Specialist II 10/2017 to 05/2023

Xtend Healthcare – Nashville, TN

Upheld high standards of customer service by building relationships with clients. Executed eligibility and benefits verification and authorization requests. Conserved confidentiality of patient finances, records, and health statuses. Settled discrepancies in insurance payments by collaborating with carriers. Followed up on denials, late payments, extensions and other special circumstances. Researched and resolved routine and complex issues. Medical Biller 05/2016 to 09/2017

Nthrive – Nashville, TN

Engaged with insurance providers to resolve denied claims and resubmitted. Affirmed insurance of patients to determine eligibility. Posted payments and collections on regular basis.

Established accuracy of accounts payable payments, resulting in 25% reduction in payment errors and check reissues.

Managed accurate records of customer payments.

Medical Biller 10/2014 to 06/2015

Radiology Alliance – Nashville, TN

Communicated with insurance providers to resolve denied claims and resubmitted. Verified insurance of patients to determine eligibility. Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.

Posted payments and collections on regular basis.

Audited and corrected billing and posting documents for accuracy. Patient Account Representative 06/2014 to 09/2014

Cymetrix – Nashville, TN

Worked with outside entities to resolve issues with billing, claims and payments. Contacted patients after insurance was calculated to obtain payments. Electronically submitted bills according to compliance guidelines. Posted payments and processed refunds.

Medicare Billing Specialist 10/2012 to 05/2014

Parallon Business Solutions LLC – Hendersonville, TN Communicated with insurance providers to resolve denied claims and resubmitted. Verified insurance of patients to determine eligibility. Collected payments and applied to patient accounts. Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers. Responded to customer concerns and questions on daily basis. Medical Coding and Billing Specialist 02/2012 to 05/2012 Brentwood Family Care Center – Brentwood, TN

Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement. Attained up-to-date knowledge of coding requirements through continuing education courses and certification renewal.

Communicated with insurance companies to research and resolved coding discrepancies. Correctly coded and billed medical claims for various hospital and nursing facilities. Accounts Payable Clerk 10/2002 to 04/2011

Kroger – Nashville, TN

Reviewed vendor invoices for appropriate documentation and validity prior to payment. Prepared vendor invoices and processed incoming payments. Maintained good working relationships with vendors and resolved disputes. Applied proper codes to invoices, files, and receipts to keep records organized and easily searchable.

Updated accounting ledgers and journals to balance statements and maintain consistent records.

Education

Career Diploma: Medical Billing And Coding 05/2012 National College of Business And Tech-Lexington - Lexington, KY

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