Medical Billing Service Representative

Objective

To be a professional in the ever-changing career of the Medical Healthcare, there will always be a need for individual’s that are knowledgeable about medical billing and coding for physicians.

Experience

Emergency Medical Associates 2008 – PRESENT

Reimbursement Specialist

Responsibilities include working on correspondence sent in by patients.

Submitting all bills to insurance such as: Worker’s Compensation, Auto, Medicare, Medicaid and Commercial carriers.

Submitting written appeals to non -par insurance carriers so the claim can be reprocess for additional payment.

Speaking directly to patients and resolving issues.

Gathering all documentation for patient’s disputing charges, unhappy with services and forwarding to Supervisor for patient satisfaction department.

Discounting and adjusting all PBS accounts for patient’s that have Charity Care for the cash department.

Creating bills and handling incoming faxes from attorneys.

Covering and answering phone calls for Inpatient Medical Associates Team, EMO & CEP Department.

Biomet Technologies 2006-2008

Patient Service Representative

Customer Service Representative processing orders for surgical supplies for the patients

Working directly with the Patients insurance companies to process claims.

Appealing claims with Medical Insurance to resolve payment issues.

Horizon Blue Cross Blue Shield 2006-2007

Claims Reimbursement Analyst

Started as a temporary employee recapping money from facilities.

Worked full -time in Call Center in Correspondents Department answering enrollment and healthcare benefit questions for members regarding the Customers Medical Health Plans.

Also worked in CIU Cross Functional Team responsibilities include adjusting all professional claim to pay in-network for hospitals, Skilled Nursing Facilities and Acute & Sub-acute facilities

Trained on systems NASCO, ERISCO, PIBA, and UCSW.

Education

Dover Institute 2010-2011

Surgical Technologist Program Courses Completed

FUNDAMEDNATALS OF SURGICAL TECHNOLOGY

MEDICAL TERMINOLOGY 1&2

MICROBIOLOGY

ANATOMY AND PHYSIOLOGY 1&2

PATHOPHISIOLOGY

PHARMACOLOGY & ANESTHESIOLOGY

SURGICAL TECHNIQUES LAB 1&2

MEDICAL LAW & ETHICS

SURGICAL PROCEDURES LABORATORY1&2

CDM Institute 2006

CBCS Medical Billing & Coding Certification Courses Completed

National Healthcare Association

MEDICAL TERMINOLOGY

MEDICAL BILLING AND CODING

ICD-9 CODING AND CPT-4 CODING

ANATOMY & PHYSIOLOGY

Skills

SOFTWARE & SYTEMS EXPERIENCE MASTERED

Medi soft 400 system, Chart view (Demographics & ER notes)

Application Extender (View all EOB and Insurance declines)

Medicare & Medicaid Website

Microsoft Word & Microsoft Outlook

Moyer-Brown billing system

NASCO, ERISCO, PIBA, and UCSW Processing Systems

References

Name Contact Information

Tawanna Outlaw 973-***-****

Bessie Koontz 908-***-****

Karen Hubbard 908-***-****

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