Data Entry Medical Billing
Resume:
Salome Sea
Killeen, TX, ***42 253-***-****
adtxbl@r.postjobfree.com
Detail-oriented professional with a focus on deadlines and the assurance that all medical billing is handled efficiently and without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information. Along with exceptional data entry and customer service skills.
Expert in MS Word, Excel, Outlook and PowerPoint. Customer Service
Proficiency in Medisoft, E-Clinical and Sweet programs. Spreadsheets
Paper/Electronic Claim Submission Collection Calls
Accounts Receivable Detailed Oriented
ICD 9/ICD 10/CPT Coding
Medical Insurance Denials/Appeals
Great understanding of UB-92 and HCFA 1500 billing requirements
EXPERIENCE
Care National May 2022-Current
Claims Examiner
Responsible for claims processing, research and adjudication to correctly apply benefit determinations on routine uncomplicated medical claims (CMS 1500 and UB40) in accordance with claim processing guidelines.
Reviews all output reports to ensure accurate benefits.
Completes reports to ensure prompt payment of claims.
Identifies and review problems systematic or procedural with Supervisor for timely follow-up and correction.
Consistently meet/exceed productivity standards and accuracy standards for payment.
Performs additional duties as assigned.
Maintains confidentiality regarding rules around HIPPA guidelines.
Home Care Provider May 2017 - Jun 2020
Disabled Husband, Killeen, TX
lAssisted with personal care, including bathroom functions, bathing, grooming, dressing, and eating.
lFollowed a prescribed healthcare plan, assisting with exercise and administering medication.
lEnsured the house is organized and meet the safety needs. Assisted with housework.
lProvided emotional support and encouragement to perform necessary tasks.
lProvided mobility assistance, helped the patient in and out of bed, or chair.
lTransported and escorted the patient to medical and other appointments.
lMonitored and reported changes in health, behavior, and needs to the doctor.
Medical Biller- Accounts Receivable Sep 2016 - Apr 2017
Integrated Health Management, Killeen, TX
lCorrectly and accurately obtain CPT codes with ICD-10 diagnosis.
lEnter charges and submit claims to insurance companies.
lUpdate patient demographic information to insurance companies.
lGuarded against fraud and abuse by verifying all coded data accurately reflect services provided.
lCollected payments and applied to patient accounts.
lReviewed patient diagnosis codes to verify accuracy and completeness.
lEvaluate data from various sources to enter in computer system.
lPrepared accounts with past due balances of more than 30 days and transferred those cases to collection agency.
lMeet deadlines by managing time properly.
Insurance Billing Clerk Feb 2016 - Jun 2016
CGC Southwest Management, Temple, TX
lBilling for Chiropractic, family clinics and pediatrics.
lOrchestrated day-to-day operations of billing department, including medical coding and payment posting, accounts receivables and collections.
lProcessed insurance company denials by auditing patient files, researching procedures and diagnostic codes to determine proper reimbursement.
lTranslated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
lFiled and updated patient information and medical records.
lLiaised between patients, insurance companies and billing office.
lCommunicated with insurance providers to resolve any denied claims and resubmit.
lDevised new methods to make workflows more efficient and brought suggestions to attention of supervisor.
lSubmitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
lPromoted consistent accuracy of billing information by reconciling 150 accounts monthly
Billing Clerk-Early Out Insurance Nov 2014 - Jun 2015
Financial Corp of America, Austin, TX
lUse data entry to input billing and insurance information correctly into system.
lFollow up on unpaid claims and denials.
lReview EOB's for proper payment.
lMonitored outstanding invoices and performed collections duties.
lProcessed payment via telephone and in person with focus on accuracy and efficiency.
lHandled account payments and provided information regarding outstanding balances.
lMaintained current accounts through aged revenue reporting.
lManaged billing calendar and scheduled claims for payments.
lCommunicated with insurance providers to resolve any denied claims and resubmit.
lLiaised between patients, insurance companies and billing office.
lManaged efficient and accurate processing of invoices.
EMS Billing Specialist Feb 2012 - Aug 2012
City Of Killeen, Texas, Killeen, TX
lPrepare monthly reports on status claims.
lSubmit paper claims and e-claims daily for Medicare and Medicaid and follow-up monthly.
lOversee bad debts and prepare information for collection agency monthly.
lPerform basic arithmetic for daily deposits of cash, checks and credit card.
lEnter patient's demographics into computer system using Sweet program.
lGenerated and submitted invoices based upon established accounts receivable schedules and terms.
lManaged efficient cash flow reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.
lPerformed targeted collections on past due accounts aged over 30 days.
lTrained and mentored new team members and managers on accounts payable systems and policies to build cohesive groups and promote operational performance.
lUtilized talents and expertise to complete on-time and accurate monthly closing processes, journal entries and accruals.
Office Manager Apr 2011 - Sep 2011
Chicoine Chiropractic, Killeen, TX
lEnter charges and post payment and adjustments.
lWork A/R, denials and collections.
lInterview and gather pertinent information face to face or via phone.
lPerform clerical duties by registering new patients and checking patients in/out.
lWork with patient's attorneys and/or 3rd party insurance company.
lOversaw fiscal operations, including accounting, budgeting, authorizing expenditures and financial reporting.
lMonitored and evaluated personnel performance to complete annual reviews, recommend advancement or address productivity concerns.
lOptimized organizational systems for payment collections, AP/AR, deposits and recordkeeping.
lMaintained computer and physical filing systems.
lTracked and recorded expenses and reconciled accounts to maintain accurate, current and compliant financial records.
lAssessed processes and procedures, complying with state, federal, OSHA, HIPAA regulations.
lDeveloped policies and procedures for effective practice management.
lDirected patients to exam rooms, fielded questions and prepared for physician examinations.
EDUCATION
High School Diploma June 1992
Lakes High School, Lakewood, WA
Arts, Business Fundamentals and Accounting May 2020
University of Phoenix, Tempe, AZ
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