Billing and Claims Specialist with 15+ Years Experience

E l i z a b e t h R o d r i g u e z

Bayville, New Jersey • 917-***-****• *********@*****.***

Professional Summary

Detail-oriented Billing and Customer Service Representative with over 15 years of experience in medical and behavioral health billing. Forward-thinking and reliable professional with a strong work ethic and proven expertise in claim processing, insurance verification, denial management, and customer relations. Skilled in working with Medicare, Medicaid, and commercial insurance providers to ensure accurate and timely reimbursement. E x p e r i e n c e

OCTOBER 2014 – PRESENT

Billing Representative Bright Harbor Healthcare Bayville, New Jersey

• Verify client eligibility and follow up on denied or delayed claims from insurance companies.

• Prepare and submit electronic and paper claims to multiple insurance providers.

• Collaborate with providers to ensure accurate coding and billing in compliance with payer requirements.

• Generate, post, and maintain claim documentation and payment records.

• Mail monthly statements to clients and provide assistance with billing inquiries.

• Process customer payments and update accounts receivable databases.

• Obtain authorization and maintain documentation in the EHR system. MAY 2006-OCTOBER 2014

Family Care Sabbatical

• Provided full-time care and managed household operations, strengthening organizational, multitasking and problem-solving skills.

January 2001-MAY 2006

Assistant Supervisor of Client Accounts Federation Employment and Guidance Services New York, NY

• Supervised and trained billing staff on claims management and denial follow-up.

• Analyzed private insurance and managed account receivables to ensure accuracy.

• Reviewed and validated charges and corrected errors to meet billing compliance standards.

• Re-submitted denied claims to achieve financial target and reduce outstanding debt. December 1999-JANUARY 2001

Client Account Specialist Federation Employment and Guidance Services New York, NY

• Processed Medicaid and third-party insurance claims and monitored denial remittances.

• Verified client attendance and submitted accurate billing to Medicaid personnel.

• Communicated with customers and insurance representatives to resolve billing issues. S k i l l s

Medical and Behavioral Health Billing • Insurance Verification • Team player • EHR and Billing Software • Microsoft Office • Customer Service and Communication • HIPAA Compliance • Administrative Support E d u c a t i o n

Bachelor of Arts in Sociology/Minor in Psychology Hunter College New York, NY

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