406-***-**** firstname.lastname@example.org Helena, MT
Medical Billing Specialist
SUMMARY OF QUALIFICATIONS
oDedicated professional with 16+ years in the medical and healthcare field with expertise in obstetrics billing and coding, patient care, insurance enrollment and claims investigation.
oExperienced with working in various environments including nursing homes, assisted living facilities, urgent care, and hospital settings.
o Proficient in billing claims and working with specialty providers, EMR systems, CPT coding, ICD-10 coding, and A/R calling.
oMotivated with the ability to quickly adjust to meet the needs of the role with efficiency and accuracy. Currently pursuing a Medical Billing & Coding Certificate.
Medical Billing & Coding Certificate – In Progress
DeVry University - Helena, MT
B.A. in Health Science in Health Science - May 2014
Carroll College - Helena, MT
Medical Information Analyst Patient Care Coordinator May 2021 to Present
AbbVie, Helena, MT
Receives and processes approved medical inquiries including speaking with the caller, coordinating follow-up action, documenting requests and responses, and developing, maintaining and updating the database files. Receives, triages, and processes product identification calls.
Responsible for Unsolicited Requests (Sales Representative/MSL) case data entry clean up and auditing.
Assists with the processing of outgoing responses via database and hard copy mailings.
Assists and collaborates with the Operations department on the Medical Information portal.
Responsible for Medical Information shared mailbox triage and handling.
Identifies Adverse Events and Quality Complaints to triage appropriately.
Runs Reconciliation Reports per Compliance.
Coordinates Global Scientific Information requests.
Billing Specialist, Office Administrator February 2020 to Present
Origin Health Maternal Fetal Medicine, Helena, MT
Collect co-pays and other fees required prior to the office visit or treatment.
Verify insurance coverage and assist the billing department with processing claims.
Communicate test results to patients when directed by physicians or nursing professionals.
Inform patients of credit card declines and other billing issues.
Submit and bill claims for insurance.
Claims and insurance handling.
Disputes and resolution of remittance
Passport Provider Lead, Enrollment Representative April 2016 to June 2017
Xerox ACS, Helena, MT
Responded to customer inquiries in a call center environment including gathering information, researching and resolving inquiries and logging customer calls.
Worked with providers, processed passport agreements, closed passport numbers, and merged passport provider's caseloads from individuals to groups.
Informed customers about services available and assessed customer needs.
Provided assistance, training and troubleshooting support to lower level staff.
Scheduled work to ensure accurate phone coverage, monitoring priority of calls and shifting escalated calls.
Prepared standard reports to track workload, response time and quality of input.
Assisted with planning and implementing department goals and makes recommendations to management to improve efficiency and effectiveness.
Phlebotomist March 2015 to September 2016
St Peter's Hospital, Helena, MT
Performed specimen collection on patients of all ages served by the hospital.
Worked on the laboratory information system to document specimen collection information, order testing, and determine medical necessity.
Transport specimens to testing areas and assess samples for appropriate labeling and acceptability.
Provided detailed and complete collection instructions to patient customers for specimens to be collected by the patient.
Phlebotomist/CNA/Medical Scheduler September 2010 to September 2012
Urgent Care Plus - Helena, MT
Collected blood and urine specimens utilizing sterile technique.
Performed waive testing such as flu, strep, pregnancy, and mono set up to run CBC, chemistry panels and other lab tests.
Administered medications under the direction of the MD or PA, including injections, set up and started IV's.
Administered EKG's, spirometry tests and other procedures as directed by nurses or Doctors.
Provided insurance options to low income patients with no insurance.
Proficient in proper sterilization of medical instruments and successfully completed extensive HIPPA training.