Medical Billing & Coding Specialist Resume Title

Donald Holder

Toledo, OH ***** 419-***-**** *************@*****.***

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Summary

Detail-oriented Medical Billing and Coding Specialist with expertise in healthcare revenue cycle management, insurance claim processing, and medical record documentation. Proficient in ICD-10, CPT, and HCPCS coding systems with strong knowledge of Medicare, Medicaid, and commercial insurance requirements. Skilled in electronic health records (EHR) systems, claims submission, denial management, and accounts receivable follow-up. Demonstrated ability to ensure accurate coding compliance, maximize reimbursement, and maintain patient confidentiality while supporting healthcare providers in delivering quality patient care. Strong analytical skills with attention to detail and commitment to staying current with healthcare regulations and coding updates. Skills

Windows 10

Office

Word

Excel

PowerPoint

ICD-9 training

ICD-10 training

CPT training

HCPCS training

Outlook

Procedural coding

Medical coding

PNM (Medicaid portal)

Availity (clearinghouse)

Kipu Health (EMR)

Collaborate MD (clearinghouse)

Advanced MD (EMR)

Simple Practice (EMR)

Icannotes (EMR)

Best Notes (EMR)

SunWave (EMR)

Experience

CREDENTIALING ASSISTANT 03/2025 - 06/2025

Brookfield Recovery - Brookfield, Ohio

Medicaid provider credentialing

Assisted in verifying credentials for healthcare professionals and staff members. Maintained accurate records in credentialing databases and tracking systems. Scheduled interviews and meetings for credentialing review processes efficiently. Supported onboarding processes by preparing necessary credentialing documentation. PAYMENT POSTER 03/2024 - 10/2024

Skypoint Recovery - Akron, Ohio

Processed and posted payments accurately to patient accounts daily. Maintained detailed records of payment transactions in company software systems. Processed incoming payments from patients and insurance companies in a timely manner. Procedural Coding

BILLING SPECIALIST 03/2022 - 12/2024

Vital Health - Maumee, Ohio

Facilitated prompt handling of daily claim submissions through streamlined processing. Maintained accurate records by tracking claims status and providing regular updates. Addressed rejections and denials to improve overall claims management. pt. Data entry as new information arrived

Posting all transactions

MEDICAID BILLING SPECIALIST 06/2018 - 07/2020

A Better Life to Embrace - Maumee, OH

Implemented billing system (Simple Practice)

Implemented EMR system (Icannotes)

Ongoing billing

Aging Claims

Eligibility Check

Credentialing (Medicaid)

Procedural Coding (Mental Health & Substance Abuse) BILLING SPECIALIST (CONSULTANT) 03/2020 - 03/2020 St. Paul's Community Center - Toledo, OH

Assist with Medicaid and Medicare credentialing

Implementation of EMR system

Medicaid billing training

MEDICAID BILLING SPECIALIST 02/2019 - 03/2020

Absolute Better Care - Toledo, OH

Implement EMR system (Simple Practice)

Aging Claims

Patient Data Entry

Posting Payments

Weekly reports

Tracking Productivity

MEDICAID BILLING SPECIALIST (CONSULTANT) 04/2018 - 08/2018 Sarah Outreach Center - Toledo, OH

Implemented EMR system

Aging Claims

Eligibility Check

Patient Data Entry

Weekly Reports

MEDICAID BILLING SPECIALIST (CONSULTANT) 04/2018 - 07/2018 Helping Young People Excel - Toledo, OH

Implement EMR system

Work effectively with medical payers such as Medicaid Medicare and commercial insurance. Ongoing Billing

Procedural Coding

Posting payments

Weekly reports

MEDICAID SPECIALIST 02/2015 - 06/2017

Empowered For Excellence - Toledo, OH

Aging Claims.

Ongoing Billing.

Analyzed medical records to satisfy insurance company mandates. Research and follow up on denied claims.

Oversaw all billing for Medicaid PCA, commercial insurance and private pay clients. Trainer for new billers.

Education and Training

Professional Skills Institute - Toledo, OH Medical Billing Coding Specialist 07/2021

ABLE Adult - Toledo, OH GED

07/2007

Certifications

Certified Billing and Coding Specialist (CBCS)

Accomplishments

Was awarded the Allied Health Professionalism Award for providing safe care through understanding and following policies and procedures, working effectively with other members of the health care team and exhibiting honesty to both co-workers and patients.

References

References available upon request.

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