Medical Billing Specialist

Dianna Davis MCBC – Medical Billing Specialist

Lula, GA 30554 678-***-**** ******.******@*****.***

PROFESSIONAL SUMMARY

Dedicated and seasoned professional with a proven track record encompassing 14 years as a successful business owner and an additional 9 years of comprehensive experience as a general manager. Transitioning into a Medical Billing Specialist role, leveraging a robust foundation in business operations, financial acumen, and adept leadership. Possesses a strong understanding of diverse business facets, including operations management, financial administration, and strategic decision-making. Committed to delivering exceptional medical billing expertise, integrating entrepreneurial insight with managerial proficiency to ensure meticulous and efficient billing processes within the medical industry.

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 February 2023 – May 2023

Medical Billing Specialist Program: AMCA: MCBC Certified

PROFESSIONAL EXPERIENCE

Longstreet Clinic Revenue Cycle Representative December 2023-Present

Customer Service & Collections

●Proficiently manage patient accounts, monitor aging reports, implement effective collection

strategies to ensure timely payments, reduce outstanding balances and improve overall revenue cycle management

●Navigate EPIC and Citrix to locate patient accounts and accurately provide information regarding balances as well as increase revenue and reduce outstanding balances.

●Place both outgoing and incoming calls in a call center environment while attending to the patient’s concerns and collecting and posting payments to the patient’s account.

●Documenting within EPIC any and all communication with patients.

Emergency Billing LLC Gainesville, GA August 2023 – October 2023

Patient Aging & Collections

●Proficiently managed patient accounts, monitored aging reports, implemented effective collection strategies to ensure timely payments, reduced outstanding balances, and improved overall revenue cycle management

●Navigated various portals such as Gammis, Palmetto, Inovalon, and Availity, conducted thorough insurance verifications for specific service dates, confirmed coverage details, ensured accurate billing, resolved discrepancies, and facilitated seamless reimbursement processes

●Utilized the Medisoft program to locate patient information, communicated effectively with patients regarding billing matters, successfully employed a system to facilitate patient outreach, addressed inquiries, and provided necessary information related to billing and financial aspects to patients for healthcare services received

Clipper Petroleum Gainesville, GA December 2014 – March 2023

General Manager

●Implemented strategies that resulted in a 5% increase in quarterly sales and showcased a proactive approach that positively impacted revenue

●Instituted measures that effectively lowered annual turnover by 10% and demonstrated an ability to enhance employee retention and organizational stability

●Consistently maintained precise data entry, delivered exceptional customer service, emphasized attention to detail, and committed to customer satisfaction

CPC Services Buford, GA January 2000 – November 2014

Owner / Operator

●Spearheaded the creation and development of the company, showcased entrepreneurial initiative and leadership, and established a successful business from its inception

●Acquired and managed multiple builders and contractors and exhibited strong negotiation and relationship-building skills crucial for successful project execution and expansion

●Oversaw Accounts Receivable (AR), Accounts Payable (AP), Human Resources (HR), Payroll, and Billing functions, sustained the growth trajectory of construction cleaning services, delivered consistently high-quality services, and contributed to the company's upward trajectory

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