Senior Medical Billing Specialist (20+ Years)

Kathy Tharle

717-***-**** ***************@*******.***

Summary

Medical billing specialist with over 20 years of experience preparing, correcting and posting claims for commercial and government payers. Skilled in identifying and resolving billing edits and clearinghouse rejections using systems such as Oscar, Medical Mastermind and Centricity. Proven ability to manage high volumes of claims accurately and meet tight deadlines while maintaining patient confidentiality.

Skills

• Soft Skills: Organized, Team Player, Hardworking, Reliable

• Technical & System Skills: Insinq System, Main Frame, Opis, Oscar, Windows-based Technologies

• Industry Knowledge: Medical Billing Experience, Cash Management and Knowledge Management Library Experience

Highmark-IBC Dec 2014 - Aug 2023

Claims Processor Camp Hill

• Obtain approvals from Blue Square to process adjustments in a timely manner

• Research for Equian Invoices monthly to evaluate if claims need to be processed/adjusted.

• Process backend claims through Oscar to pay or deny using Windows-based technologies

• Retrieve CRNs through the CMS for claim research, adjustment, and closure Women’s Institute Jan 2013 - Nov 2013

Claims & Medical Biller York, PA

• Keyed in charges for the doctor and two CRNPs in a timely manner, demonstrating strong medical billing experience

• Verified patient and insurance information and updated any new information.

• Managed the check-in and out of patients for the office.

• Handled outstanding bill reports by working with collection agencies.

• Maintained patient statements, balances, and refund checks.

• Posted insurance payments to patient accounts, ensuring accurate balance reconciliation Practice Management Partners Aug 2008 - Jul 2010

Reimbursement Specialist

Applied payments to customers accounts using the following software Medical Mastermind, Azio Lite and Centricity Physicians Office. Researched credits and denials on customer accounts to resolve billing issues Balance all accounts for monthly cutoffs Wyntre Brooke Surgical Associate Jul 2006 - Apr 2008 Claims & Medical Biller York, PA

• Coded and Keyed in Office claims and claims for the Wound Center

• Received/verified all patient and insurance information & applied payment.

• Researched Workmen’s Comp. Insurance, files for referral and other details needed.

• Filed and ran reports daily.

Mid-Atlantic Cardiovascular Associates Jul 2000 - Dec 2005 Claims & Medical Biller Maryland

• Billed Claims and special holter monitors to Insurance for 9 Cardiology Physicians.

• Entered demographic diagnosis/procedures into CBSI & Mega West billing software.

• Researched/verified insurance information and posted charges/payment on a daily basis.

• Ran pre-log of daily charges and made corrections

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