Theresa Raine Juezan MCBC – Medical Billing

Specialist

Mt. Juliet, TN 37122 615-***-**** ad3ai5@r.postjobfree.com PROFESSIONAL SUMMARY

Dedicated and versatile professional with a proven track record as an admissions clerk, psychiatric tech, and customer service representative handling both inbound and outbound calls. Adept at managing health insurance benefits and claims with a strong background in ensuring customer satisfaction. Seeking to leverage comprehensive skills in the dynamic field of medical billing, bringing a unique blend of healthcare knowledge, customer service expertise, and administrative acumen to excel as a medical billing specialist. PROFESSIONAL SKILLS

• Identify major laws, regulations and guidelines related to medical billing

• Understand various insurance types, carriers and plans and appropriate rules for coverage determination

• Recognize ICD-10-CM, CPT, HCPCS and modifiers and how to utilize them for billing

• Accurately complete and submit heal insurance claims for reimbursement

• Comprehend payment adjudication, various claim statuses and the resubmission process

• Gather, review, and verify crucial patient information and documentation

• Audit medical billing and prevent fraud and abuse assigning diagnostic and procedure codes and how to submit clean claims for reimbursement

• Submit reimbursement claims to insurers and optimize healthcare providers maximum payment for medical procedures performed

EDUCATION

MedCerts Livonia, MI June 2023 – October 2023

Medical Billing Specialist Program: AMCA: MCBC Certified PROFESSIONAL EXPERIENCE

MTMHI Nashville, TN October 2022 – March 2023

Admissions Clerk

• Proficiently handled administrative office tasks and responsibilities

• Managed both inbound and outbound calls and ensured effective communication and customer service

• Set appointments, accurately entered data, and contributed to well-organized and streamlined operations MTMHI Nashville, TN May 2021 – September 2

Psychiatric Technician

• Provided compassionate and attentive patient care services

• Collaborated with the healthcare team and supported and delivered quality patient care

• Demonstrated strong interpersonal and communication skills and assisted in various aspects of patient care

SPI Inc. Dumaguete November 2016 – July 2017

CSR

• Inbound and outbound calls facilitate direct and real-time communication, allowing swift exchange of information between parties

• Inbound calls offer a platform for customers to seek assistance, while outbound calls enable businesses to proactively engage clients, enhancing overall customer relationship management

• Supported sales efforts and resolved customer queries promptly Online Job Remote February 2014 – February 2015

Administrative Assistant

• Utilized provided leads, created targeted email campaigns, fostered engagement, and drove potential clients toward conversion

• Streamlined property management tasks, updated listings, maintained an organized database, and ensured accurate and up-to-date information

• Engaged in proactive client prospecting (Craigslist posting, internet research, appointment setting, and data entry) and contributed to the overall growth and efficiency of the business Teletech Inc. Dumaguete May 2010 – December 2012 CSR

• Proficiently inputted and maintained customer information, policy details, and healthcare-related data into the system, ensured precision and complied with established protocols, and facilitated smooth claims processing

• Effectively communicated complex healthcare insurance benefits to customers, provided clear and concise information about coverage, co-pays, deductibles, and other relevant details, and enhanced customer understanding and satisfaction

• Facilitated the timely and accurate processing of insurance claims, collaborated with internal departments, healthcare providers, and customers, resolved claim-related issues, and ensured a seamless experience throughout the claim’s lifecycle

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