Medical Billing Service Representative

Syretta Anderson MCBC – Medical Billing Specialist

Menifee, CA 92584 619-***-**** *********@*****.***

PROFESSIONAL SUMMARY

Dedicated Medical Billing Specialist with exceptional customer service skills seeking entry-level positions within the Medical Billing Specialist field. Over 10 years in the healthcare with proven experience in managing multiple tasks successfully. Committed to maintaining professional relationships to ensure exemplary patient care. Looking for opportunities that offer an excellent team culture and professional growth and development.

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 health 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 Dec 2022 – Aug 2023

Medical Billing Specialist Program: Graduated

We Care Online Classes Healthcare Industry Wichita, KS Jun 2014 – Jul 2017

Health Unit Coordinator Course

University of Phoenix San Diego, CA Mar 2012 – Mar 2014

Studied Science of Communications: 32 credits towards bachelor’s degree

Pima Medical Institute San Diego, CA Jan 2004 – Oct 2004

Achieved Medical Assistant Diploma

PROFESSIONAL EXPERIENCE

Tri-City Orthopaedic Surgery Medical Group Oceanside, CA Nov 2023- April 2024

Patient Coordinator

Verify Eligibility and Benefits

Request Prior Authorization for Medical Procedures, Durable Medical Equipment, and Specialty Drugs

Inbound and Outbound calls with Medical Insurances, Medical Offices, and Patients regarding: Commercial, Medicare. Medi-Cal, and Tri-care insurances

Copy, Print, and Fax Approved and Denied letters.

United Parcel Service Moreno Valley, CA Nov 2022 – Dec 2022

Personal Vehicle Driver (Seasonal)

Carefully packed and unpacked boxes

Provided quality customer service from beginning to end of transactions

Worked in collaboration with other departments to ensure exceptional customer service with delivery

Adhered to safety rules while operating vehicles during deliveries

Home Instead Senior Care Murrieta, CA July 2019 – Nov 2022

On-Call Supervisor Caretaker

Responsible for answering all phone calls and communication that are considered urgent and need to be prioritized to the office prior to opening

Responded to all client inquiries and asked appropriate questions to facilitate resolution

Wrote reports regarding Caregiver’s work status, and client’s conditions, moods, background information, and progress notes

Established and updated work schedules to account for changing staff levels and expected workloads

Dexcom San Diego, CA Nov 2018 – Jan 2019

Billing Account Representative

Handled inbound customer calls related to unpaid claims, outstanding balances, and related reimbursement topics

Handled outbound calls to customers to perform account follow-up/or to collect payments for overdue bills

Developed rapport with clients and vendors to cultivate loyalty and satisfaction interpret medical policy, explanation of benefits (EOB), and other insurance documents

Reduced billing errors and improved timely and full payments for Medicare primary, secondary and supplemental, and private parties through keen insurance eligibility verification

Covance San Diego, CA Nov 2017 – Aug 2018

Program/Reimbursement Specialist

Performed benefit investigations (Outbound calls to government and commercial plans to confirm eligibility, relayed Summary of Benefits to healthcare providers)

Inbound and outbound call from and to clients’/patients to respond to inquiries or to notify them of claim investigation results or any planned adjustments

Reported product complaints and adverse events

Enrolled patients into Financial Assistance Programs

File Clerk for customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken

Letter of Recommendation and References available upon request

Contact this candidate