Customer Service Medical Billing

PROFESSIONAL SKILLS

Strong organizational skills: able to effectively prioritize work daily, capacity to maintain

Corporate compliance, excellent multi-tasking skills and the ability to follow up on open

Items in a timely manner.

Strong computer skills, including expertise in database management; advanced proficiency

in Salesforce, MS Office applications such as Microsoft Office and Excel.

Strong interpersonal and writing skills to communicate both verbally and in writing with

with patients, providers and management.

Excellent interpersonal and communication skills by positively interacting with personnel,

patients, providers and insurance carriers in all settings.

Team Building: Extremely skilled at adapting to projects and resolving issues independently.

Proficient in Nextgen, Medical Manager, Citrix and Optum.

EXPERIENCE:

2007-Present - Medical Billing Representative II, NextGen Healthcare, Hunt Valley, MD

2005-2007 - Charge Entry Specialist, NextGen Healthcare, Hunt Valley, MD

2002-2005 - Medical Billing Rep I and Customer Service Billing Rep II, Practice Management Partners, Inc. Owings Mills, MD

JOB RESPONSIBILITIES:

Audit upon review of accounts to determine status and appropriate action required from

workflow generated from practice management system. Document accounts according to SOP’s and CMS guidelines.

Research and follow-up on denials and requests for additional information utilizing denial.

management reports and correspondence along with writing appeals to insurance

companies.

Resolve transferred requests from the Customer Service Team to resolve complex issues.

Navigate facility correspondence websites, phone to contact payers regarding reimbursement for unpaid accounts.

Collaborate with management to identify payer trends and non-payment issues.

Identify, verify, and document account adjustments according to established policy and

Procedures.

Ensure service level and productivity are met as it relates to reimbursement of accounts, resolution of tasks and response to inquiries.

Maintain positive working relationships and partner with internal and external customers by providing superior customer service.

Communicate with payers about re-filing claims that were underpaid plan/provider errors.

Comprehensive understanding of EOB’s to ensure payment accuracy and compliance.

EDUCATION:

Edmondson HS

Representative II,AR Management

Contact this candidate