Customer Service Accounts Receivable

DONNA WILLIAMS

760-***-**** *************@*****.*** MEDICAL BILLER

PROFILE SUMMARY

Dedicated Medical Biller with 10+ years of experience in Accounts Receivable, Billing, and Coding, showcasing excellence in the ever-evolving medical sector. Holds a deep-seated knowledge of HIPPA and PHI regulations, guaranteeing unwavering compliance with privacy and security measures. Adept in various medical coding systems such as CPT, ICD9, ICD10, and HCPCS, catering to a wide array of medical fields including DME, Orthopedics, OB/GYN, Radiology, General, and Vascular Surgery. Exhibits comprehensive skills in all dimensions of medical billing, from insurance verifications, authorizations, and medical records management to collections, payment posting, and managing accounts receivable and payable.

Diligently reviewed over 800 accounts daily, markedly minimizing the volume of pending accounts.

Crafted and implemented a strategy for the fair distribution of tasks among team members, nurturing a synergistic and productive work environment.

Received the "Employee of the Month" award in recognition of outstanding customer service.

Launched a rewarding Incentive Plan, granting an hour of compensatory leave for employees completing a full workweek, thereby boosting morale and efficiency.

AREA OF EXPERTISE

Medical Terminology Coding Expertise Claim Processing Payment Reconciliation Accounts Receivable Insurance Verification HIPAA Compliance Medical Software Data Entry Account Management Denial Appeals

Record Auditing Regulatory Guidelines Customer Service Communication Billing Policies Problem-Solving Skills Time Management Payment posting

TECHNICAL SKILLS

Oracle Allscripts EPIC Office Ally Cerner VitalWorks MS Word Google Docs

PROFESSIONAL WORK EXPERIENCE

Customer Service Associate

2023 – 2024

Walmart Poway CA

Demonstrated accuracy in handling of return merchandise, bill pay by customers, sending and receiving transactions

Delivered superior customer service skills by answering all queries customer had

Occasionally was tasked with working in other departments of store placing merchandise in correct home

Cashier 2022 – 2023

Jimbos, San Diego, CA

Demonstrated proficiency in handling cash transactions and managing financial records, ensuring accuracy and efficiency in daily cashier duties.

Enhanced customer satisfaction by delivering exceptional service, addressing inquiries with empathy, and resolving issues promptly delivered exceptional customer service by promptly addressing inquiries and resolving issues, maintaining a 98% customer satisfaction rate over two years.

Sabbatical Career Break 2020 – 2021

Took a planned career break to prioritize familial responsibilities, managing household duties and attending to personal matters.

Leveraged organizational skills to oversee daily schedules, activity planning, and coordinating needs across multiple family members.

Maintained proficiency by engaging in self-directed learning, reading industry publications, and attending relevant webinars/workshops.

Volunteered with local community organizations, honing interpersonal abilities and demonstrating continued initiative during sabbatical period.

Medical Biller Med Legal Assistant 2020 – 2020

San Diego Hand Specialists

Expertly managed medical billing processes, ensuring accurate and timely submission of claims to various insurance companies, significantly reducing claim denial rates.

Demonstrated proficiency in coding medical procedures and diagnoses with ICD-10, CPT, and HCPCS codes, leading to a 20% increase in revenue recovery.

Streamlined patient billing inquiries by developing a comprehensive FAQ section, reducing call volume by 30% and enhancing patient satisfaction.

Assisted legal teams with medical record analysis and interpretation, facilitating the preparation of detailed reports for personal injury cases, contributing to a 25% increase in successful settlements.

Implemented electronic medical records (EMR) system, improving record-keeping efficiency and compliance with HIPAA regulations, resulting in a 15% decrease in paperwork processing time.

Reimbursement Specialist 2014 – 2019

Dexcom, Inc., San Diego, CA

Expertly managed all aspects of medical billing, including accurate coding with HCPCS, ICD9, and ICD10, entering system changes, ensuring timely claims submission to Medicare, Medi-Cal, HMOs, and PPOs, and diligently followed up to secure payments.

Led successful collection efforts, contacting patients for payment negotiation and updating information, resulting in the recovery of 80% of overdue receivables and enhancing patient financial responsibility awareness.

Excelled in patient communication, informing them of insurance benefits and co-payment obligations, and resolving inquiries with professionalism, thereby improving patient satisfaction and balance resolution rates.

Enhanced billing efficiency by organizing patient profiles, reviewing and updating information as needed, and preparing and submitting claims to insurance carriers, ensuring accurate reflection of payments and insurance reimbursements.

Streamlined the appeals process by filing first and second level appeals and effectively resubmitting claims, coordinating with physicians for clinical documentation, and verifying treatment authorization, leading to successful insurance resolutions.

Benefits Coordinator 2014 – 2014

Kelly Services, San Diego, CA

Coordinated comprehensive benefits packages for over 200 employees, ensuring seamless access to health, dental, and vision plans, while maintaining a 98% satisfaction rate among employees.

Liaised between healthcare providers and employees, facilitating the resolution of complex billing issues and advocating for fair and accurate charge practices, reducing billing discrepancies by 25%.

Implemented an innovative electronic billing system that streamlined the claims process, improved tracking efficiency by 40%, and significantly reduced paper waste.

Conducted detailed audits of current benefits and billing procedures, identifying key areas for improvement that led to a 20% cost reduction in benefits expenses without compromising coverage quality.

Developed and delivered informative training sessions on benefits enrollment and healthcare billing to employees, enhancing their understanding and efficient use of healthcare resources.

Accounts Receivable Specialist 2013 – 2014

Intermedix Corp, Wheatridge, CO

Led accounts receivable operations for a healthcare provider, reducing outstanding receivables by 25% within the first year through diligent follow-up and negotiation techniques.

Implemented a comprehensive billing system that streamlined medical billing processes, resulting in a 15% faster reimbursement rate and significantly improving cash flow.

Conducted detailed audits of patient accounts and insurance claims to identify and rectify billing inaccuracies, ensuring compliance with industry standards and reducing claim denials by 30%.

Developed and maintained strong relationships with insurance companies, leveraging expert knowledge of medical billing codes and regulations to expedite dispute resolution and payment processes.

Led a team of billing specialists in a high-volume medical office, training staff on best practices for efficient accounts receivable management and customer service excellence, leading to a 20% improvement in patient satisfaction scores related to billing inquiries.

PROFESSIONAL DEVELOPMENT

Collection Seminars

Reimbursement seminars

Certified Medical Biller

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