Medical Billing Service Representative

**** ******** *** ******, ** ***** Cell 323-***-**** **************@*****.***

Medical Billing / Collections

Responsible detailed oriented health care professional with 5yrs experience in a call center environment. Highly experienced in resolving outstanding issues, reconciling insurance and patient payments. Proven ability to complete assignments and meeting deadlines with limited supervision by learning new skill quickly and taking charge. Dedicated to maintaining strict patient confidentiality.

Skills

ICD-9, CPT, HCBCS

Medical Terminology

Patient Registration

CMS-1500 & UB-04

Medical Insurance

Insurance Verification

EOB's & COB’s

Claim Submission

Authorization Request

MS Word & Excel

Appeals & Reconsiderations

HIPPA Compliance

Experience

United HealthCare Hearing, Pomona, CA 2014 – 2020 Customer Service Representative Assist system admin with operations request, and data entry of master data, testing new implementation request for process errors and loop holes in system before going live. After receiving promotion from role of Medical Biller.

Oversee regular reporting to ensure that claims are processed and sent out on schedule.

Cross check system to ensure that patients data is complete and accurate for claims processing.

Ensured quality of bills by diligently prepare all required claims sent electronic / paper claims with necessary documents to reduce incidence of denials.

Researched and resolved denials and rejections in a timely manner.

Acted as a liaison between accounting department, provider office, and manufacturers to resolve invoice errors.

Process patient statements and request credit and rebills to appropriate payer.

Maintain accountability by entering refunds and adjustments into system and forwarding to management to be applied.

Eric E. Gofnung Chiropractic Corp, Los Angeles, CA 2008 - 2011 Assistant Collector / Biller Process Work Comp claims for Chiropractic office

Provided tenacious follow up to ensure proper payments were fully corrected.

Developed workflow process and protocols to ensure billing accuracy.

Request authorization for treatment, filed for liens, application of adjudication

Education

Medical Billing HealthCare Examining – American Career College, Los Angeles, CA

Diploma – Centennial High School, Compton, CA

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