Billing Coordinator Medical Insurance
Resume:
Marcus Young
Billing Coordinator - Help At Home LLC
Chicago, IL 60616
************@*****.***
To secure a position where my 10 years in the field of medical Insurance claim procedures, billing, repricing, investigating and all related duties are needed. Work Experience
Billing Coordinator
Help At Home LLC - Chicago, IL
March 2018 to Present
• Processing billing according to contract regulations and requirements
• Complete billing, resubmitting, cash posting support, adjusting payer codes, making payer code changes, processing refunds, auditing documents, researching and resolving problems
• Meeting all billing deadlines
• Collect, analyze and summarizing information, producing reports and responding to requests
• Communicating progress and any issues with supervisor on a regular basis
• Developing and maintaining working relationships with company personnel in branch offices, as well as with contract-holder representatives
• Miscellaneous billing duties, tasks and projects assigned Claims Specialist
Family Health Network - Hillside, IL
March 2016 to January 2018
• Processing ICP/HCFA/HOSPITAL claims via VITA claims systems
• Approving/Denying claims needing authorization for payment
• Examines claim form and other records to determine insurance coverage.
• Analyzes claims to determine eligibility, medical facts, policy coverage and limitations.
• Approves claims at the appropriately demonstrated assigned authority level. Medical Claims Processor
Chicagoland Medical Servs Organization - Chicago, IL February 2015 to February 2016
• Entry of Professional Claims received on a HCFA
• Entry of Facility Claims received on a UB
• Verification of accuracy of the claim as inputted in the entry process
• Determination of the authorization status of each claim. Including assessment of the validity of incoming authorizations/memorandums etc
• Evaluation of Quick Cap denial/payment accuracy
• Forwarding claims to BC/BS and Unicare as indicated by status Claims Coordinator
Allied Benefit Systems, Inc - Chicago, IL
May 2003 to September 2014
• Re-priced and Investigated HCFA/UB claims discounts from a host of PPO networks
• Processed 180-250 claims daily
• Call notes & Referral claims processing - Daily basis within a 24hr turnaround time
• Processed claims am/pm reports for the day
• Processed medical claims - surgery, physical therapy, ER, diagnostic tests, etc.
• Utilized HCPCS level III, ICD-9 and-3 for the coding EDI Team Coordinator (Allied Benefit Systems, Inc. )
• Transferred & processed files from Blue Cross Blue Shield to Allied (FTP website)
• Tracked file downloads via BCBS inbound process count form and also file types via check list sheet
• Updated patient eligibility (Rims 5 system)
Education
Diploma
Cregier Vocational High School
Certificate
American Technical College
Skills
• CLAIMS (10+ years)
• CODING (10+ years)
• ICD (10+ years)
• ICD-9 (10+ years)
• BILLING (Less than 1 year)
• Medical Billing
• Invoicing
• CPT coding
• ICD-10
• EDI
• Medical Coding
• FTP
• Epic
• Hospital Experience
• Medical Records
• Microsoft Excel
• Microsoft Office
• Medical coding
• ICD-10
• ICD-9
• EDI
• Accounting
• Medical terminology
• ICD coding
• Epic
• DRG
• Research
• Medical records
• Documentation review
Additional Information
SKILLS
A team player, responsible and self-starter with in-depth knowledge of medical insurance claim procedures. Knowledge of medical billing procedures, insurance claims etc. Excellent communication skills both verbal and written. Computer skills: MS excel, MS word, MS outlook and Word Perfect.
•Medical Terminology
•Keyboarding 50 WPM
•Computer Medical Billing
•Accounting
•ICD-9
•HCPCS Coding
•CPT Coding
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