Customer Service Billing Specialist
Resume:
PROFESSIONAL SUMMARY
Detail-oriented certified medical biller/ medical office specialist, with
strong understanding of bookkeeping principles and customer service. Experienced in developing and managing efficient billing and posting processes. Considered focused and organized team player, With over 9 years experience.
WORK HISTORY
Medical Billing Specialist, 03/2024 - Current
North Florida Orthopedic, Tallassee, TN
Claim Resolution Specialist, 05/2014 - 01/2017
Fresenius Medical Care Holdings Inc., Tallahassee, FL Tallahassee, FL 32304
*********@*****.***
SKILLS
ASHLEY JONES
Communicated with insurance providers to resolve denied claims and resubmitted.
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• Posted and adjusted payments from insurance companies. Communicated effectively and extensively with other departments to resolve claims issues.
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• Located errors and promptly refiled rejected claims. Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
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• Identified and resolved patient billing and payment issues. Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
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Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
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Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
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Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
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Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
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Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
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Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
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• Collected payments and applied to patient accounts. Contributed to team success by consistently meeting or exceeding individual performance metrics for claim resolution.
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• HIPAA compliance
• Payment posting
• Claim submission
• Insurance verification
• CPT knowledge
• Patient billing
• Denial management
• ICD-10 proficiency
• Medicare and medicaid process
• Medical coding expertise
• Bill payment
• Accounts payable
• Files and records management
• Insurance billing
• Medical terminology
• Billing and collection procedures
• Critical thinking
• Customer service
• Electronic claims
• Teamwork and collaboration
• CMS-1500 billing forms
• Electronic health record software
• Multitasking and organization
• Work prioritization
Knowledgeable in Epic, click point
care, Athena, eclinical works,
advanced md, paychecks, time and
attendance system
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Medical Billing Specialist, 09/2023 - 03/2024
North Florida Therapy Services, Quincy, Fl
Medical Billing Specialist, 01/2022 - 09/2023
The Medical Healing Center, Tallahassee, FL
Lead Medical Biller, 01/2020 - 08/2022
Positive Behavioral Support. Co, Tallahassee, FL
Achieved high customer satisfaction ratings by providing prompt, empathetic, and accurate resolutions to claims.
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Provided exceptional customer service throughout the resolution process, fostering client trust and loyalty.
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Increased accuracy in claims assessment through meticulous record-keeping and organized documentation.
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• Precisely evaluated and verified benefits and eligibility.
• Filed and updated patient information and medical records. Coordinated with other departments to address any discrepancies or concerns related to charge capture or data entry accuracy.
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• Liaised between patients, insurance companies, and billing office. Efficiently processed refunds or adjustments for patients when necessary, ensuring accuracy and compliance with company policies.
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Prepared billing correspondence and maintained database to organize billing information.
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Printed and reviewed monthly patient aging report and solicited overdue payments.
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Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
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Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
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Precisely completed appropriate claims paperwork, documentation and system entry.
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Monitored changes in payer requirements, adjusting billing practices accordingly to minimize disruptions in the revenue cycle.
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Participated in departmental meetings, sharing insights and ideas for improving overall medical billing efficiency and revenue generation.
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Collaborated closely with the clinical team to ensure proper documentation was obtained for accurate billing purposes.
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Increased overall efficiency of the billing department by regularly auditing internal procedures and suggesting improvements.
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Developed customized reports for management review, highlighting trends in key performance metrics such as claim denial rates and days outstanding for accounts receivable balances.
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Collaborated with healthcare providers to obtain necessary documentation for accurate billing submissions.
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Monitored changes in insurance policies, keeping abreast of updates affecting medical billing procedures and informing staff
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Office Manager/Billing Specialist, 02/2017 - 01/2019 Wellness Integrated Healthcare, Tallahassee, FL
EDUCATION
accordingly.
Managed electronic health record systems, ensuring data integrity and accessibility for authorized personnel.
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Continually sought opportunities for professional development by attending industry conferences and participating in relevant workshops to improve knowledge of medical billing best practices.
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Developed comprehensive training materials for new hires, facilitating their smooth transition into the medical billing team.
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Resolved complex billing issues by conducting thorough research, working closely with insurance providers to reach favorable outcomes for both parties involved.
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Led a team of billers, providing guidance and training to ensure timely completion of tasks.
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Implemented new software solutions that increased productivity within the department while reducing administrative burden on staff members.
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Assisted patients in understanding their medical bills, addressing concerns and clarifying any confusion regarding charges or insurance coverage.
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Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
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Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
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Maintained accurate financial records by reconciling accounts payable/receivable transactions regularly to ensure balanced budgets.
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Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
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Enhanced team productivity by delegating tasks effectively and overseeing daily workflow.
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Coordinated office events and meetings, ensuring timely execution and optimal scheduling for all participants.
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Streamlined office operations by implementing efficient filing systems and organizational strategies.
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Served as a liaison between upper management and staff members, facilitating open channels of communication to address concerns or issues promptly.
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Facilitated smooth communication between departments, addressing concerns promptly to maintain harmonious work relationships.
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Oversaw facility maintenance requests, coordinating with building management to address repairs or improvements efficiently.
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Improved team morale and cohesion with regular team-building activities and open communication channels.
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Handled sensitive employee and client information with utmost confidentiality, maintaining trust and integrity.
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Medical Office And Billing Specialist, Health Sciences, 05/2020 Ultimate Medical Academy - Tampa
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