Medical Biller and Coder with 14+ Years Experience
Resume:
PROFESSIONAL PROFILE
Enthusiastic and dedicated professional with over 14 years of experience in Hospital Medical Billing, currently seeking an opportunity as a Medical Biller and Coder. Works with a positive and professional demeanor with exceptional problem-solving skills. Passionate about overseeing tasks from start to finish.
EDUCATION
Brightwood College Towson, MD
February 2017- June 2018
Medical Billing and Coding Program
CPR/AED Certified (AHA)
SKILLS
*ICD-9/ICD-10 *HCPCS CPT *TruCode Medical Coding *UB-04 Reimbursement
*Medicare Billing /Collections *Medical Records Management
*CMS 1450 & 1500
*Accounts Receivable *Financial Reporting *Insurance Verification
*EPIC SYSTEM *IDX SYSTEM
CERTIFICATIONS
Certified Medical Billing & Coding
OSHA through Brightwood College
HIPAA through the Center for Medicaid/Medicare Services
CPR/BLS and First Aid though the American Heart Association
PROFESSIONAL EXPERIENCE
Professional Experience
University of Maryland Faculty Physicians
Accounts Representative II
January 2022- November 2024
Reconciled Refunds/Credit Accounts
Draft refund letters to different providers.
Reconciling claims for ENT, Surgical Neurology and Surgical department
Responsible for submitting and resubmitting claims
Followed up with insurance companies on unpaid claims.
Submitted appeals for rejected claims.
Communicated with both commercial and government payors.
Working on different EOB’s
Checked patient’s eligibility status.
Patient customer service
Medstar Healthcare
Medstar Ambulatory Surgery Center
Medical Biller (Contract)
May 2019 - March 2020
●Reconciled the 2015-2018 aging AR aged report.
●Submitted and resubmitted 2019 to current 2020 claims.
●Submitted appeals for rejected claims.
●Communicated with both commercial and government payors.
●Working different payers EOB’s
●Checked patient’s eligibility status.
Smart Pain Management
October 2018 – November 2018
Medical Biller (Contract)
●Responsible for submitting and resubmitting claims
●Followed up with insurance companies on unpaid claims
●Submitted appeals for rejected claims
●Adjustments
●Communicated with both commercial and government payors
●EOB’s
●Checked patient’s eligibility status
Intersect Healthcare / Appeal Masters
September 2017- May 2018
● Reviewed and maintained medical billing and claim records, settlements and medical
insurance statements for multiple facilities
● Created and submitted claims to various insurance companies, ensuring their accuracy by contacting patients,health
insurance companies
● Responsible for the collection, posting, and management of account payments.
● Ran all aging reports on claims processed
Johns Hopkins University School of Medicine
February 2003 – February 2018
Insurance Specialist
● Uses A/R follow-up systems and reports to identify unpaid claims for collection/appeal
● Gather and verify all information required to produce a clean claim including special billing procedures that may be def
defined by a payer or contract.
● Review and update patient demographic and insurance information as needed
● Prepare delinquent accounts for transfer to self-pay collections unit per the follow-up matrix
● Print and mail claim forms and statements based on the follow-up matrix
● Retrieve medical records, authorizations, etc. to submit to third-party payers
● Appeal reflected claims and claims with low reimbursement
● Confirm credit balances and gather necessary documentation to process refunds
● Process daily mail, edit reports, file or pull EOB batches
Contact this candidate