Medical Billing Customer Service
Resume:
Bersetta Maria Kirby
Cell. 720-***-****
Professional Summary
● Medical field for over 20 years.
● Experience in billing Medicaid, Medicare, Commercial Insurance, Customer Service and Medical Collections.
● Strong attention to detail, excellent multi-tasking and team player with a positive attitude.
● Efficient courteous service, answering inbound/outbound calls, answering general correspondence about patients billing and E.O.B's.
● Provide account research for patients, setting up a payment plans, discussing patient balance on their account and doing follow-up with them and the insurance company.
● Updating patients accounts with insurance information/addresses and all vital information, while following HIPAA laws and guidelines.
● Reconciliation of account analysis, credit balances while explaining to patients about their insurance deductibles and co-insurance.
● Maintains strict confidentiality.
● Knowledge of HMOs, Medicare Medicaid.
● Electronic Medical Record (EMR) software.
● Medical billing software.
● Patient-focused care.
● Team player with positive attitude.
● Deadline-driven.
● Good written communication.
Education
● High School Diploma Richwood High School - Peoria, ILL, U.S.A Kaiser Permanente
8/2019 - 2/22
Call Center Rep
● Customer Service
● Handled approximately 60 - 70 inbound calls a day.
● Schedule pt appointments and answer their questions.
● Setting up appointments for the Covid testing and for the Covid Vaccine.
● Taking verbal orders from the provider line for the Dr.s
● Scheduling for other departments.
● Taking patients request to change to a different Dr. or Clinics
● Answering questions about the Covid Vaccine.
Experience
10/2018 - 06/2019
US Oncology
Medical Records/Insurance Specialist
● Customer Service.
● HIPPA laws.
● Handled approximately 50 – 60 inbound and outbound calls per day.
● A/R Report.
● Pulling Medical Records.
● Sending thru web portal or certified mail.
● Appeals and reconsideration.
● Follow up with Insurance on claims.
● Electronic Billing.
Eating Recovery Center
4/2016 - 8/2018
Claims Specialist
● Made approximately 50 - 60 outbound calls to payers to follow up on submitted claims.
● Prepares claims for re-bill by pulling up accounts from the system.
● Calling insurance company about claims and taking payments from patients.
● Follows up claims through resolution /collection.
● Post EOB’s, payments, A/R follow-up, patient eligibility, authorizations, and resubmitted appealed/denied claims.
● Pulls up EOBs /ERAs to research reasons for denials.
● Verifies eligibilities through web portals or through phone calls to insurance companies.
● Appeals and researches denied claims.
● Used Microsoft Excel daily for reports.
● Adjustments on patients’ accounts.
● Explaining to patient their out of pocket network their deductible and co-insurance. 06/2011 - 11/2015
Revenue Enterprises
Customer Service / Collections
● Handled approximately 50 – 60 inbound/outbound calls daily, arranging payment plans on accounts into centricity the software system used.
● Analyze and research patient accounts, problem solve discrepancies within patients’ accounts, detail oriented and meet deadlines.
● Confidentiality regarding patient information, release of information followed by federal/state regulations and guidelines.
● Resolving billing and reimbursement issues while enter up-date changes into billing software. 02/2009 - 05/2011
Favorite Staffing Services – University Hospital
Medical Billing / Customer Service
● Handled between 40 and 50 calls per day.
● Doctors office meeting and greeting patients.
● Carefully reviewed medical record for accuracy and completion as required by insurance companies.
● Recorded and filed patient data and medical records.
● Wrote clear and detailed clinical phone messages for physicians.
● Acquired insurance authorizations for procedures and tests ordered by the attending physician.
● Scheduled patient appointments.
● Completed registration quickly and cordially for all new patients.
● Confirm patient information collected co-pays and verified insurance billing claims. 08/2003 - 11/2008
Senior Care of Colorado
Medical Billing
● Medical billing, 50 – 60 inbound/outbound calls per day, carefully reviewed medical records accuracy and
● completion as required by insurance companies.
● Coded outpatient encounters, accurately entered procedure codes, diagnosis codes and patient information into billing software.
● Appropriately and correctly identified error and re-filed denials /rejected claim as they were received from the patient account representative.
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