Accounts Receivable & Medical Billing Specialist
Resume:
Andice Downer
Accounts Receivable/Billing Specialist
Bridgeport, CT 06605
************@*****.***
Professional Summary
Experienced Account Receivable/Billing Specialist and Remote Customer Service Representative with over 10 years in the healthcare industry. Skilled in managing billing systems, coordinating with major insurance providers both private and commercial, and delivering exceptional remote customer support. Extensive billing knowledge of FQHC, Behavioral Health and Hospital billing practices. Adept at using CRM systems, EHR platforms, and billing software to ensure accuracy, efficiency, and compliance with HIPAA standards.
Willing to relocate: Anywhere
Authorized to work in the US for any employer
Work Experience
Customer Service Representative (Remote)
Aetna, a CVS Health Company
November 2024 to September 2025
• Responded promptly to customer inquiries via phone, email, and chat
• Provided accurate information about products, services, and policies
• Resolved customer issues efficiently, escalating complex cases when needed
• Maintained detailed documentation in CRM systems and followed company guidelines
• Collaborated with other departments to improve customer experience Medical Billing Account Manager (Hybrid)
CT Renaissance-Shelton, CT
August 2023 to September 2025
• Accounts receivable and billing management
• Utilize billing software to process and track invoices ensuring data accuracy
• Communicate with insurance companies to discuss billing policies and resolve claim denials
• Review and approve billing adjustments, discounts, and credits per company guidelines
• Safeguard client records in compliance with HIPAA standards
• Ensure Providers are credentialed with different insurance and fee schedules are up to date.
• Run aging reports and communicate with clients and insurances regarding outstanding payments and balances.
Medical Billing Specialist (Remote)
CPa Medical Billing-East Haven, CT
August 2021 to August 2023
• Managed accounts receivable and FQHC billing processes
• Hospital and Outpatient billing
• Communicated with patients and insurance companies regarding billing issues and policies
• Collect and process insurance and patient payments
• Medicare billing
• insurance verification
• Process appeals and denials
Medical Billing and Coding Specialist
Sanitas Medical Center-Bridgeport, CT
April 2019 to September 2021
• Outpatient billing
• Monitor outstanding balances
• Manage insurance claims, invoices and payments
• Collect copayments and deductibles
• Insurance verification
• Process insurance denials and appeals
Certified Nursing Assistant (CNA)
Cassena Care Of Stamford-Stamford, CT
June 2017 to November 2019
• Providing housekeeping duties
• Administer bedside and personal care Implementing and supporting client care plan and documenting care provided
• Provide nursing care to patient to achieve maximum level of independence CNA - Certified Nursing Assistant
Solace Home Healthcare-Stamford, CT
November 2014 to November 2017
• Preserve patient dignity and minimize discomfort while carrying out duties
• Assisted patient with activities of daily living including helping with meals
• Effectively communicate with client to fulfill needs proper Education
Medical Billing & Coding (Certified Billing and Coding Specialist) Training Direct-Bridgeport, CT
Pre-Nursing (Associate of Science)
Housatonic Community College-Bridgeport, CT
Medical Billing & Coding (Associate's degree)
Skills
• Handling patient inquiries
• Medical claim denial management
• Inpatient
• Centers for Medicare and Medicaid Services (CMS)
• Insurance Claims & Appeals
• EMR systems
• Electronic Health Record (EHR) access control systems
• Revenue cycle analyst experience in medical billing and coding
• Medical administrative support - Medical administrative support experience (6-10 years)
• Hospital experience
• Medical insurance appeals management
• Medical billing data reporting
• Attention to detail
• Insurance medical billing
• Outpatient
• EDI
• Insurance claim appeals processing
• Patient billing
• Contracts
• EHR systems
• Administrative experience
• Workers' compensation claims
• Managing patient records
• Electronic health records (EHR) management
• Medical collection
• Documentation review
• Revenue cycle management
• Telehealth administrative experience
• Payment posting in medical billing systems
• Epic (4 years)
• Medical billing specialist experience
• Medical Terminology
• Medical Records
• Appeals
• Supervising experience
• Achieving HIPAA compliance
• Accounts receivable
• EMR/EHR
• Patient insurance coordination
• Telehealth platforms
• Medical billing
• Insurance verification
• Medical payment processing
Languages
• English - Fluent
Certifications and Licenses
AHIMA
Medical Billing Certification
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