Medical Billing & Revenue Cycle Specialist
Resume:
Tatianna Johnson
**** ***** ****** ****** ***. 204 Rockford, IL 61101
773-***-**** *****************@*****.***
PROFESSIONAL PROFILE
Patient centered professional who demonstrates independent work initiative, sound judgment, and attention to detail. Backed by 19+ years of healthcare industry experience and the problem-solving skills essential in reviewing and resolving billing and coding issues. Understands the patient treatment process and familiar with hospital workflows.
Serve as liaison between physician, patient, and insurance carriers
Able to initiate insurance collection process
Strong verbal, written and interpersonal communication skills
Process payer appeal requests and physician and insurance changes
Understand compliance regulations such as Medicare, Medicaid, Managed Care, and HIPAA
Microsoft Office Applications / MS Excel MS Word MS PowerPoint MS Outlook
Communication Platforms: Skype Zoom
Typing Speed: 30 WPM
KEY QUALIFICATIONS
Medical Billing Accounts Receivable Collections Co-Pay Deductibles Co-Insurance EOBs
Revenue Cycle Management Posting Payments Government (Medicare & Medicaid) Third Party Payers
Electronic Health Records (EHR) Electronic Medical Records (EMR)
Managed Care (HMO, PPO, and POS) Workers Compensation Medical Office Procedures Scheduling
Insurance Verification Insurance Claim Processing CMS 1500 CMS 1450 (UB-04) Front Office Operations
Medical Terminology Anatomy & Physiology HIPAA Compliance Medical Coding (ICD-10-CM, HCPCS, CPT)
EDUCATION
Ultimate Medical Academy Associate of Science Degree – Medical Billing and Coding, 2021
Ultimate Medical Academy HIPAA Essentials for Healthcare Professionals Certificate
PROFESSIONAL EXPERIENCE
Mercy Healthcare Javon Beau Hospital Rockford, IL 03/2021 – Present
Medical Claims Specialist
Make outbound phone calls to insurance companies in order to follow up with medical claims and bills
Handle explanation of benefits and work with outsource agencies with bad debt claims
Review claims that have gone through insurance process and correct denied claims
Modify and change codes in a timely manner and submit coded charts to insurance companies
Answer inbound phone calls, reassign ICD-10 and CPT codes, and resubmit claims
Process appeals, denials or collections and perform coding for hospitals, inpatient, and outpatient procedures
Post payments and process Medicare, Medicaid, and 3rd party billing
Submit Superbills and act with discretion when handling confidential information
Private Duty Care Oak Park, IL 04/2007 – 07/2018
Caregiver
Assisted with activities of daily living – personal hygiene and grooming
Prepared and served meals and handled light housekeeping duties, and ran errands
Transported to locations outside the home and scheduled appointments
Monitored medication intake and communicated effectively with medical staff
Additional work experience includes 8 years as a Medical Claims Specialist
Contact this candidate