**** ******* **** *****• Antioch, TN 37013
615-***-**** • Email:email@example.com
Medical Billing and Coding Diploma (GPA 3.66) Kaplan College, Nashville TN Expected 06/2015
Dean’s List, Honor Roll, Perfect and Excellent Attendance Awards
HIPAA & OSHA trained
First Aid trained
CPT, ICD-9/10 & HCPCS
CMS-1500 & UB-04 claims
OPTUM and Virtual Medical Office EMR
Government & private insurance
Instamed/G4 Centricity/eClinical Works
Medical billing procedures
A/R & A/P
Microsoft Office Suite
Strong communication skills
Customer service skills
Fast to learn new things
Excellent verbal communication
Payment Poster -team lead Integrated Oncology Network, Nashville TN 01/2020 to Present
Post all payments and adjustments: ensures all payments and adjustments are balanced on a daily basis
Resolves any deposits that are unable to be posted to include no tickets left unsettled
Review manual and electronic explanation of benefits to assure proper posting
Refers claim resolution issues to the appropriate area
Works closely with front office in regards to their deposits
Alert supervisor of collection problems noticed
Ability to maintain a high volume of payments within a 48 hour work window
Must be able to work at a fast pace, and troubleshoot payment problems with minimal supervision and also interact with payers professionally
Ability to work overtime/stay late for end of the month close process if needed
Post refunds in the billing system as received from Accounts Payable
Perform any outstanding conveyance as distributed by supervisor
Working closely with management to meet goals, develop new techniques, policies and procedures
Regular attendance and punctuality.
Contributes to team effort by accomplishing related results as needed.
Ensures that all processing and reporting deadlines are consistently achieved.
Perform any other functions as required by management.
Underpayment Analyst Parallon (HCA), Nashville TN 01/2018 to 12/2019
Perform second validation of discrepancy reason code assigned by the Discrepancy Analyst
Contact payer and initiate request for payment
Perform appropriate follow up with payer for payment as appropriate
Escalate contract issues to the Supervisor
Other duties as assigned
Identify trends in underpayment/overpayments, denials, revenue opportunities and revenue leakage
Review contract validation, updates and interpretation
Resolve underpaid claims in an effective and timely fashion
Review of payer policies for impact on reimbursement
Insurance Customer Service Rep AIG, Brentwood TN 08/2017 to 12/2017
Process lockbox remittance mail: opening and scanning of exception payments, logging of overnight packages, and review of reinstatement payments.
Process a variety of premium and file maintenance transactions to apply and reverse premiums, process mode changes, cancellations, lapses, and other transactions as relates to billing and collection.
Maintain accurate, well-documented case files.
Insurance Payment Posting/Workers Comp Pain Management, Antioch TN 05/2015 to 02/2017
Posts payments and adjustments exceptions from an electronic file, and ensures each batch is balanced daily.
Posts payment and adjustments from bank lock-box and ensures each batch is balanced daily.
Posts other types of payment and adjustments from collection agency, interoffice transfers, time of service and credit card payments.
Reviews Explanation of Benefits to assure proper payment and adjustment has been received.
Verifies appropriate financial classification status is loaded into registration.
Performs other duties as assigned.
Work with Medicare part B and D
Front Office/Reservations Hilton Downtown, Nashville TN 05/2011 to 05/10/2013
Provide quotes for room rates and up-sell the guest, assist in coordinating the Front Desk and Housekeeping
Verify posting correct charges and credits to the corresponding guest folio and collect payments
Ensure all cash and cash equivalents balanced at the beginning and end of each work shift
Night Audit Sheraton Downtown, Nashville TN 03/2011 to 12/2011
Front desk agent answering phones, registering guests, accepting payments, and providing customer service
Prepared the hotel’s books for the day’s financial transactions primarily data entry of accounting work in system