Medical Billing Customer Service

Edna Whitmire

**** ******* ** *******, ***** ****7 281-***-**** cell 713-***-**** ****.********@*****.***

SUMMARY OF QUALIFICATIONS

Highly organized and detail-focused Senior Medical Billing Specialist with an exceptional record of accomplishment of accurately handling billing and financial responsibilities in deadline-oriented environments.

Proficient in Medical Insurance Billing and Collections, Medical Terminology, Medical Coding, and Medical Transcription. Strong knowledge of ICD-9, CPT coding and HCPCS, for commercial, worker’s comp, lien, Medicaid and Medicare claims using CM1500 and UB92 forms.

Excellent computer skills; proficient with various medical billing software’s, Microsoft Word, Microsoft Excel, Great Plains, and QuickBooks. Able to learn proprietary systems/applications quickly and easily.

Proficiency in managing accounts payable and accounts receivable transactions, generating invoices and monthly patient statements.

Proven ability to identify and implement improvements to streamline processes and increase efficiency and productivity.

Hardworking, motivated, energetic, dedicated, and professional individual able to serve clients in a conscientious and pleasant manner.

Strong ability to multi-task, organized, disciplined and detail oriented.

Skill Proficiencies

• Medical Billing

• Accounts Payable/Receivable • Patient Statements

• Process Improvement • Medical Terminology

• Reconciliations

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PROFESSIONAL EXPERIENCE:

Deans Professional Service-Assignment Texas School of Business September 2010-Present Position: MOS INSTRUCTOR/Medical Billing and Coding Instructor

Instructor for Medical Office Specialist/Medical Billing and Coding, Billing, medical terminology, study of the body systems, coding, HIPPA, collections, the importance working and law of medical field.

Medical Reimbursement of America/Contract February 2011-July 2011

Position: Client Relation Associate

To obtain account Documents and get information on: Assign accounts to MRA-assigned at registration UB,

Itemized statements, EOB’s, AOB’s, Third party ,Medicaid, Medicare, all insurance accessing client notes as well as entering notes in clients systems. Authorization numbers, medical records. First report of injury information, payment and adjustment information. Implant device invoices. Please Bill Letters, scanned documents such as insurance card, letters from the attorney’s, remittance advises, etc. Handling all correspondence and phone calls from the patient’s attorneys, patients and adjusters, etc. Working pending request spreadsheets, working close and return report and doing the adjustments. Insurance Billing procedures for Medicare, Medicaid and other insurances

CHRISTUS Health/TLRA/ LK Jordan Associates Temporary February 2009-July 2009

Position: Medical Accounting Specialist/Collection

Payment posting of payments from patient, payroll deduction, insurance, patient research on accounts, epays credit card payments, uploads pull from the S drive and posted payment balancing each batch. File batches in folder for each month.

Reviews EOB/EOMB’s for proper reimbursement

• Resolves electronic claim rejections on EOB denials in a timely manner

• Follow-up on unpaid or unresolved account balances. Provides insurance carriers with requested information to facilitate payments

•Regularly contacts Medicare, Medicaid and/or Commercial payors for resolution to claims not paid

•Prepares necessary journal entries

•Assists with credit balance resolution

•Monitors and analyzes routine and non-complex general ledger accounts

•Maintains communication with hospital and System Office personnel •Performs various analysis and special projects as directed by their supervisor

•Liaison with Patient Financial Services

• Prepares routine monthly general ledger account reconciliations thoroughly and timely. Reviews entries, verifies amounts, and compares balances for reasonableness and deviation from source documents. Proposes correcting entries with account reconciliations as needed

•Prepares billing and maintains systems related to non-patient accounts receivable. Ensure proper posting of charges and payments in a timely manner

•Communicates regularly with various Hospital, Service Center and System Office personnel to facilitate collection and analysis of financial data

• Adheres to all CHRISTUS and Gulf Coast Region Policies and Procedures

• Work closely with Patient Financial Services to address issues and reconciling items

• Meditech Client Server and HBOC Healthquest (McKesson) experience

• Work closely Patient Financial Services to address issues and reconciling items

Completed ad hoc assignments and analyses for Accounting Managers. Prepared reports. Excellent computer skills. Strong ability to multi-task, organized, disciplined and detailed oriented

Access MediQuip – Houston, TX. 01/2004 - 06/2008

Senior Medical Billing Specialist/Accounting Specialist/Collections

Completed medical billing for the entire company for two years. Credentialing for Physicians and made sure they could work in hospitals and outpatient facilities. Promoted to Senior Medical Billing Specialist and supervised entire billing functions and billing specia

lists to meet company’s goals and objectives. Held meetings to evaluate and delegate claim-processing obligations to meet department goals. Submitted secondary insurance claims. Generated monthly statements and invoices for patient pay obligations. Scanned claims into patient file system for record retrieval and audit purposes. Communicated with insurance companies to address inquiries and resolve issues to reduce overall timeframe for receiving payments. Researched and resolved billing and collections disputes. Researched accounts and resolved issues/questions related the Explanation of Benefits (EOB). Supported the collection staff on collecting aged receivables older than 150 days old with success. Ensured accurate and timely processing of accounting data. Performed accounts receivable functions, balancing cash and posting sales invoices. Worked with accounts payable department to post invoices. Cross trained in payroll and supported role when payroll specialist was out on vacation or sick leave. Accurately entered transactions into company's accounting system. Completed ad hoc assignments and analyses for accounting manager. Prepared management reports and financial cash/billing summaries using Microsoft Excel detailing company’s financial status on a daily basis. Performed pre- authorization and precert on patient procedures to understand the complete business flow. Verified Medicaid/Medicare eligibility utilizing various applications and registered patients in the system. Participated in development of billing procedures and update of forms and manuals. Ensured strict confidentiality of financial records. Assisted in preparing documentation and responses for legal inquiries, litigation, and court appearances in regards to lien and worker’s compensation cases.

Key Contributions:

Supported a significant increase in claims payment productivity by implementing and working with management on electronic claims processing.

Transferred all paper patient file information to electronic patient file system so paper files could be destroyed for HIPPA compliance purposes.

University of Texas Health Science Center–Houston, TX 01/2002-05/2003 Senior Coding Specialist/Biller

Responsible for daily business office functions including coding and billing for various entities throughout the organization. Entered charges for doctors. Verified insurance information, and handled pre-certification of surgery. Maintained spreadsheets and assisted where needed. Worked with all types of insurance, including workers compensation, Medicare, Medicaid, POS, HMO, EPO, and PPO. Communicated with doctor’s office and other staff. Performed clerical duties including typing, filing patient medical records, meeting deadlines. Other duties included working with HCFA 1500 and UB92 for inpatient and outpatient collections and maintained appeal log. Processed billings to patients and third party reimbursement claims. Maintained supporting documentation files and current patient addresses. Processed patient statements, posted transactions, and verified accuracy of input to reports generated. Researched and responded by telephone and in writing to patient inquiries regarding billing issues and problems. Followed up on submitted claims. Resubmitted claims as necessary. Ensured strict confidentiality of financial records.

Key Contributions:

Demonstrated talent for quickly learning new tasks and completing assignments ahead of schedule while maintaining a high degree of accuracy.

Excelled within a fast-paced environment, continually taking on increased levels of responsibility.

Continuum Healthcare System, Houston, TX 09/2000-06/2001

Corporate Billing Supervisor/Biller and Collections

Responsible for daily business functions that includes outstanding and receivable reports, supervising billing staff, overseeing the Medical Clinic in Houston and Baytown areas. Credentialing for doctors Makining sure they were condential for hospitals and surgery centers Posting of payments, billing, entering of charges. Clinic billing for Outpatient Psych, Partial Hospital Programs, TDC-Juvenile, Home Health, Insurance Verification, Precertification of Surgery, checking claim status, posting of EOBS of payment and denials, billing, filing to secondary insurance for payment. Sending statement out to patients, making payment arrangement with the patients. Communication with others, Managers, Medical staff, Clinicians, Clerical staff. Assisting with other duties when required. Working with UB92 for collection of home health, and the HCFA 1500 for collections, using customer service with employees, physicians and client, follow-ups and appeals to the insurance company. Insurance verification of patient benefits.

SKILLS Independent Medical Billing/Coding Consultant, and Collections, Billing of HFCA 1500, UB92, UB04 forms, Word Processing, MS, Excel, Clerical skills, Notary Public, Centricity, EMR, Great Plains, Emdeon, Methodist HIS and HPF systems Oracle, CUBS, Star Navigator, HBOC McKesson, Medisoft, ADP, JD Edward IDX,EDI,TDH, PC Module, Med-tec, Medic, Medical Management Software, Medisoft, SAP,UNIX, Meds America, Misystem, Virtual Medical Record, Millbrook Practice Management, Lytec Practice Management,Script, ICD-9, CPT coding, EKG/Lab, Phlebotomist, CPR and First Aid Certification, Billing, Customer Service skills, Trainer, Medical/Legal Transcriptionist for Doctors and Lawyers, Accounting and Payroll, Human Resource Training, QuickBooks 2000, Peachtree, Supervisor Experience. Coding Radiology, Internal Medical, Family Practice, Cardiology, Pediatric and Orthopedic Surgery, Oncology, Ob/Gyn Pathology, Infectious Disease, Gastroenterology. Conduct Coding and Billing Seminars and knowledge of sign languages

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