LICENSES

Certification in Medical Billing, Coding and Transcription

SKILL HIGHLIGHTS

Maintains strict confidentiality

Electronic Medical Record (EMR) software

ICD-9 coding

CPT and HCPCS coding

Interpreting instruction

Quality assessment of coded data

HIPAA compliance

Medical billing software

Strong planning skills

Patient-focused care

Strong work ethic

Team player with positive attitude

Deadline-driven

Good written communication

Exercices good jugement

PROFESSIONAL EXPERIENCE

SHAYLYN HINES

720-***-****

adsu5o@r.postjobfree.com

444 Amethyst Dr

Fruita, CO 81521

Insurance/Medical Billing Specialist, SCL Revenue Service Center, Broom- field, CO

Nov 2017-present

Business office insurance representative with BCBS and experience supporting over 75 physicians in a busy medical center. Expertise includes verifying insur- ance coverage, submitting claims, correcting claims, running daily reports, cor- recting CPT and ICD-9 and 10 codes, communicating with doctors, coders and adjudication departments to resolve insurance issues. PSR Lead, St.Mary’s OBGYN Clinic, Grand Junction, CO Aug 2018-Aug 2021

Greet patients. Answer phones, take messages, return calls and provide needed information, while documenting all phone calls accurately and completely in the electronic medical record (EMR).

Schedule patient appointments for visits, procedures, diagnostic tests, referrals and/or consultations.

Register patients. Confirm, enter, and/or update all required demographic data on patient and guarantor on registration system. Follow procedures when identi- fying patients.

Obtain copies of insurance card(s), forms of ID, and signature(s) on all required forms. Verify information on appropriate accounts to determine insurance coor- dination of benefits, pre-certification/prior authorization. Complete the Medicare Secondary Payer (MSP) questionnaire when applicable. Verify insurance to de- termine coordination of benefits and obtain authorization and/or referrals as re- quired. Screen for non-covered services and waiver of liability (ABN) through au- tomated screening at time of service.

Inform self-pay patients of liability due and prepayment requirements. Prepare estimate of procedures, calculate advance payment requirements on previous or bad debt and current balances. Refer potentially eligible patients to financial counseling and/or contract eligibility vendor(s). Refer complex or non-compliant patient financial issues to Clinic Manager or Revenue Service Center. Collect patient payments and provide accurate receipt. Post payments in sys- tem. Reconcile receipts with cash collected and complete required balancing forms. Document patient account notes for all interactions/transactions. Maintain department and/or individual work queues and reports as required. Pre- pare medical records for patient appointments by compiling information from various sources to include authorizations and non-Epic documentation. Accu- rately scan medical records as required for Medical Group or specialty office. Business Office Insurance Rep., Boulder Medical Center, Boulder, CO Nov 2016-Nov 2017

Responsible for assessing claims daily that have been denied, need resubmitted or need adjustments with coding issues or adjudication issues. Daily correspondence with insurance companies regarding claims. Manage working accounts, check eligibility benefits and respond to customer’s questions about plans and claims. Accounting Manager, All Mountain Hearth & Patio LLC, Erie, CO Sept 2011-Oct 2015

Responsible for maintaining customer invoices, following up with payments, checking the A/R daily, following up with customers, scheduling and reconciling bank information.

Senior Teller, Wells Fargo Bank, Grand Junction, CO Dec 2003-June 2004

Managed opening and closing times for the main branch. Balanced daily cash deposits and bank vault inventory with a zero error rate. Processed cash withdrawals. Trained employees on cash drawer operation. Researched and resolved customer issues on personal savings, checking and line of credit accounts. Examined checks for identification and endorsement. Processed treasury, tax and loan payments. Supplied tellers with coin and currency as needed. Maintained confidentiality of bank records and client information. Directed specific questions to appropriate branch personnel. Delivered prompt, accurate and excellent customer service.

Teller, Palisades National Bank, Palisade, CO

June 2001-April 2002

Balanced daily cash deposits with a zero error rate. Processed cash withdrawals. Researched and resolved customer issues on personal savings, checking and lines of credit accounts. Examined checks for identification and endorsement. Processed treasury, tax and loan payments. Maintained confidentiality of bank records and client information. Directed specific questions to appropriate branch personnel. Delivered prompt, accurate and excellent customer service. Teller, The Bank of Grand Junction, Grand Junction, CO June 2001-Dec 2003

Balanced daily cash deposits with a zero error rate. Processed cash withdrawals. Researched and resolved customer issues on personal savings, checking and lines of credit accounts. Examined checks for identification and endorsement. Processed treasury, tax and loan payments. Maintained confidentiality of bank records and client information. Directed specific questions to appropriate branch personnel. Delivered prompt, accurate and excellent customer service. EDUCATION

At Home Professions, Ft. Collins, CO 2015

Medical Billing, Transcription and Coding

Colorado Mesa University, Grand Junction, CO 1998-1999 General Studies, Member of Cheerleading Squad, 3.87GPA Fruita Monument High School, Fruita, CO 1994-1998 Grade General Studies, Member of Cheerleading Squad, Honor Society Academic Achievement Award, 3.9GPA

REFERENCES

Sandy Zarifa 303-***-**** Psychology Counselor

Bethany Sheer 303-***-**** Medical Biller

Wendy Wooten 970-***-**** Business Coordinator St Mary’s OBGYN

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