Customer Service Medical Biller
Resume:
EXPERIENCE
MEDICAL BILLER AND CODER
WELLMED MEDICAL MANAGEMENT/ HOMECARE DIMENSION
*Currently working seven projects: Unposted patient payments, Self-Pay Balance Disputes, Duplicate eCW accounts, Max Day Reports, Undeliverable Statements, Patient Portal Telemed Refunds and assisting my team with questions and direction.
*Maintained electronic records of all claims submitted, tracking payments received from insurance companies.
*Verified insurance eligibility and benefits using online resources and contacting payers directly as needed.
*Adhered strictly to HIPAA guidelines when handling confidential patient information.
*Identified opportunities for improvement in workflow processes related to billing operations.
*Reviewed financial documents including EOBs for accuracy and completeness prior to posting payments in the system.
*researched discrepancies in billing to determine appropriate action and resolution of payments issues.
*Provided customer service support by answering questions about medical bills or other matters relating to accounts receivables and billing processes.
*Coded patient information accurately into the practice management system according to the ICD-10 standards.
Helped review insurance denials related to diagnosis issue. Entered accurate data into billing software systems such as eCW.
*Leveraged understanding of disease process to identify and extract details and data within clinical documentation.
*Adhere to the No Surprise Act (NSA) for individuals who self-pay (patients w/o health insurance
*Responded promptly and professionally to any inquiries related to account status or payment options
*Preformed daily reconciliation tasks involving deposits adjustments refunds
*Reviewed EOBs for accuracy prior to posting payments onto patients accounts
RECONCILIATION SPECIALIST
WELLMED MEDICAL MANAGEMENT/ HOMECARE DIMENSION
2019-2022
*Maintained an up-to-date knowledge of accounting practices, regulations and new technologies related to reconciliation processes.
*Maintained multiple regions in Texas and Florida clinics daily financials while staying in compliance and accuracy.
*Provided timely feedback on reconciliations results as well as recommendations for improvement.
*Communication with more than 35 WellMed Clinics in Texas and Florida to gather all necessary documents needed for the Daily Reconciliation Process.
*Processed payments according to established procedures while maintaining high levels of accuracy.
*Performed thorough research and investigations into variances between accounts resolving any issues quickly and efficiently
*Reconciled and noted discrepancies found in records
*Sent out education emails to PSRs in the clinic for correction of incorrect totals and missing documents such as patient receipts deposit slips, copies of patient checks or insurance payments etc.
*Resolved Disputes over incorrect coding errors or denied claims within established timeframes.
*Verified patient eligibility for benefits through online systems or via phone contract with insurances companies.
*Actively participated in team meeting providing constructive feedback on existing processes and offering innovative ideas for improvement
*Ensured compliance with applicable laws regulations and standards pertaining to financial reporting
*Analyzed complex financial data from various sources including bank statements, general ledgers invoices ensuring all information was accurately entered into system
*Collaborated effectively with internal and external stakeholders to ensure accurate reconciliations of financial data
DME REPRESENTATIVE
HOMECARE DIMENSIONS/ WELLMED MEDICAL MANAGEMENT
2019-2023
*Developed effective communication skills
*Responsible for patients calling in needing DME equipment sent to them, dispatched deliveries to patients needing various services.
*Responsible for patient equipment pick-up after notification of patient deceased
*Called Insurance companies on denials on certain medical equipment
*Assisted patients with product selection based on their individual needs or preferences
* Knowledge of Medicare and Medicaid regulations and reimbursement guidelines
*Demonstrated excellent customer service skills while communication with patients regarding payment plans and account balance
*Comprehensive knowledge of medical terminology related to DME.
* Comprehensive knowledge of medical terminology related to durable medical equipment.
*Proficient in Microsoft Office Suite, including Word, Excel, Power-point, Outlook and Access.
*Managed daily administrative tasks such as filing paperwork and scheduling appointments.
*Strong Problem solving skills with the capacity to think quicker under pressure
MEDICAL COLLECTOR/PAYMENT POSTING
HOMECARE DIMENSIONS/WELLMED MEDICAL MANAGEMENT 03/2016-2019
*Successfully appealed denied claims resulting in increased reimbursement for services rendered.
*Conducted extensive research on complex medical billing inquires utilizing multiple resources
*Analyzed aged accounts receivable reports to identify trends or areas of improvement in collections process
*Performed detailed analysis of all delinquent accounts in order to determine appropriate course of action for collection efforts
Verified patient eligibility for benefits through online systems via phone contact with insurance companies
*Resolved disputes over incorrect coding errors or denied claims within established timeframes
*Identified discrepancies between billed charges and accepted payments from insurers and payers
*Demonstrated excellent customer service skills while communicating with patients regarding payment plans and account balances
*Complied monthly aging reports to review outstanding balances due from payers to patients.
*Provided exceptional customer service while responding promptly to incoming calls from both customers and insurance carriers
*Identified discrepancies between billed charges and accepted payments from insurers and payers
EDUCATION
SOUTHWEST HIGHSCHOOL
SAN ANTONIO TEXAS
JUNE 2004
High School Diploma
SAN ANTONIO COLLEGE
San Antonio Texas
KEY SKILLS AND CHARACTERISTICS
Medical Terminology • Reviewing Patient Information • Client Inquiries • Data Verification • Patient Data Complication • Client Inquiries • CPT Code Modifiers • Accounts Receivables and Accounts Payable • Active Learning • Medical Claim Coding • HCPS Level II Familiarity • Critical Thinking • Patient Account Management • P • Coding Appeals • Protected Health Information • Problem Solving • Insurance Claims Analysis • Attention to Detail • Excellent Organizational skills • ICD-10 Requirements • Electronic Health Record Applications • Maintain Patient Confidentiality • Medical Billing and Collections • Medical Billing and Coding Accuracy • Procedural Coding • Diagnostic Codes • Compliance Requirements • Electronic Health Records • Patient Account Management • Invoice Statements • HIPAA Compliance • Diagnostic Coding •CPT Knowledge •Electronic Health Records • Data Entry Accuracy• Analytical Skills •Communication Skills •Financial Data Analysis •Time Management
CERTIFICATIONS
• CERTIFIED MEDICAL CODER (CMC) PMI ID# 221365 EXP 12/31/2024 (PRACTICE MANAGEMENT INSTITUTE)
REFERENCES
Available Upon Request
SARAH ASHLEY MCCALL
SENIOR MEDICAL BILLING SPECIALIST
PROFILE
Versatile Medical Biller and Coder with a robust background in maintaining patient confidentiality and compliance requirements at WellMed Medical Management and Homecare Dimensions. Cross trained between both companies at the same time, handling multiple job duties at a time. Expert in ICD-10 coding and insurance claims analysis, with a proven track record in enhancing billing procedures. Recognized for outstanding customer experience and active learning to drive continuous improvement.
CONTACT
**********@*****.***
www.linkedin.com/in/sarah-mccall-23222b279
5930 Highfield st
San Antonio, TX 78238
ACTIVITIES AND INTERESTS
*Studying *Music *Traveling *Reading*
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