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Medical Billing Service Representative

Lancaster, CA
October 27, 2022

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Phone: 516-***-**** Email:

Address: **** **** ****** ***, *********, CA 93536 SUMMARY OF QUALIFICATIONS

Versatile, highly qualified, and dedicated Healthcare Insurance Claims Specialist Candidate with a wide range of successful hospital bill/claims processing, contracts, benefits, provider services and medical data analysis experience. Adept at analyzing various healthcare data, collaborating with vendors, preparing financial reports, and working with CPT, ICD-10, HCPCS with Modifiers, and EMR software systems. Consistently maintains compliance with various medical insurance/billing policies and regulations while managing a high volume of database entries for inventory and hospital billing initiatives. Currently seeking Healthcare Insurance Claims Specialist position by demonstrating the following skills, qualifications, and experience. AREAS OF EXPERTISE

• Healthcare Insurance Claims

• Plan/Benefit Administration

• Process Improvement


• EMR Software Implementation

• Insurance Claims Processing

• Medical Terminology

• Abnormality Identification

• Record/File Maintenance

• Medical Billing/Coding

• Account Management

• Provider/Vendor Relations

• Bill/Claims Examination

• Database Administration

• Fee Scheduling/UCRs


Optum360/Northwell Health Accounts Receivable Clerk Nov. 2018 – Present

• Responsible for working several patient accounts daily while preparing itemized bills, UB04, and medical records to be sent to various insurance carriers for payment.

• Handle all matters pertaining to patient billing and medical insurance claims processing. Coram Healthcare/CVS Infusion Pharmacy Clinical Support Specialist Jun. 2012 – Nov. 2018

• Assisted pharmacists by entering prescription data and new orders to be reviewed while contacting patients to discuss medication and supply deliveries, as well as dispensing IV antibiotics via HCN.

• Collaborate with nurses regarding patient care, manage accurate deliveries by communicating with compounding staff, and work with billing personnel to verify insurance coverage of drug therapies.

• Programmed Curlin and CADD pumps for use in patient homes, as well as enter prescription data to obtain co-payments.

New York Blood Center Clinical Service Representative Apr. 2006 – Feb. 2012

• Performed quality reviews and ensure that blood center maintains FDA compliance regarding donation procedures, as well as data processing and hospital billing.

• Managed inventory and HLA/Granulocyte order processing, as well as audited nursing department and assisted with data control, microfilming, and retention tube processing. EDUCATION & DEVELOPMENT

Hunter Business School

Medical Billing & Specialist Diploma

National Healthcare Association

Certified Pharmacy Technician

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