Authorization Specialist Medical Billing
Resume:
SIOBHAN
TAYLOR
MEDICAL BILLING
SPECIALIST
adwnwo@r.postjobfree.com
Phoenix, AZ 85042
CONTACT
Accomplished individual with 10+
years experience in the medical
field, with a comprehensive
understanding of medical coding,
billing, claims procedures, and
member and pharmacy benefits.
Experienced in using various
medical billing software and
databases.
Proven track record of successfully
resolving member and
pharmaceutical issues, and claim
billing disputes by providing
accurate and timely solutions.
Committed to delivering exceptional
customer service and building long-
term relationships with providers
and insurances.
CAREER OBJECTIVE
Medical Biller
CVS Health, Phoenix, AZ
Prior Authorization Specialist
Superior Vision, Phoenix, AZ
EXPERIENCE
May 2017 - November 2022
Epic Medical Infusion Biller for hospitals, Infusion Facilities, and Private homes. Delivered timely and accurate billing, reviewing, and posting of CMS-1500, UB-04, and secondary EOB claim forms, for Managed Medicaid, Medicaid, Medicare, TRICARE, and Commercial Insurance plans.
•
Verified according to the providers DRG order, the correct service codes, modifiers, and pricing is correctly billed on all claims in the EPIC system.
•
Liaison between patients, providers, insurance companies, and billing
• offices.
Communicating with insurances and providers to resolve denied claims, and resubmit the claims for payment.
•
October 2015 - December 2016
Using an Excel Spreadsheet, Prior Authorizations are reviewed, approved, and denied within the 72 hours of the HealthFirst Medicaid Compliance guidelines.
•
Contacted varies providers in regards to their PA request to get
• required information that is needed for an approval. Demonstrated ability to manage multiple tasks while remaining adaptable and flexible.
•
Responded quickly to meet customer and provider needs and resolve problems.
•
Associate In Arts (A.A.) In Communication
South Mountain Community College, Phoenix, AZ
Certification In Medical Assisting
Lamson College, Tempe, AZ
EDUCATION
May 2007
Relevant Coursework
• Music
May 2007
Bachelor Of Science (B.S.) In Health Care Administration Ashford University, Clinton, Iowa
Relevant Coursework
• Phelbotomy
October 2010
SKILLS
Claims Review, Medicare and Medicaid Processes, Medical Claims Submission, Invoice Processing
•
• Time Management, Regulatory Compliance, Work Prioritization Medical Coding Knowledge, Billing Codes, CPT Codes, ICD-10 coding, CMS-1500, Modifiers, Diagnositic Codes
•
• Statement Billings, Payment Posting,
• HIPAA Compliance, Healthcare Terminology,
• Information Inputting, Patient Account Analysis
• Word, Excel, Teams, Zoom, Outlook
• Obtaining Authorizations, Reimbursements,
References available upon request
REFERENCES
Contact this candidate