Amanda Smith
John Alford
Challenge,CA
Summary
Dynamic Medical Billing Manager with extensive experience at Dr Shwratz, excelling in claim submission and denial management. Proven track record of enhancing reimbursement processes and building strong relationships with insurance providers. Skilled in ICD-10 coding and effective communication, consistently improving billing accuracy and reducing claim denials.
Work History
Medical Billing Specialist
- Processed patient billing claims with attention to insurance requirements and coding accuracy.
- Reviewed claim denials and corrected errors for timely resubmission.
- Verified patient demographics, coverage details, and account information before billing.
- Posted payments, adjustments, and refunds into billing system accurately.
- Reconciled outstanding balances and followed up on unpaid claims.
- Maintained confidential medical records while supporting HIPAA compliance.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Located errors and promptly refiled rejected claims.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Liaised between patients, insurance companies, and billing office.
- Created improved filing system to maintain secure client data.
- Monitored outstanding invoices and performed collections duties.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
Medical Billing Manager
- Managed claim submission workflows, ensuring accurate coding and timely payer reimbursement.
- Resolved denied claims by investigating billing errors and coordinating corrections with clinical staff.
- Audited patient accounts for compliance with insurance policies and documentation requirements.
- Tracked accounts receivable, following up on outstanding balances and delinquent claims.
- Coordinated prior authorizations and verified insurance coverage before service billing.
- Reduced denied claims through diligent review, correction, and resubmission of errors.
- Developed strong relationships with insurance companies through effective communication and negotiation skills, enhancing payment turnaround times.
- Supervised billing processes, maintaining consistency across charge entry, posting, and collections.
- Updated billing procedures to improve accuracy, reduce rework, and support compliance standards.
Medical Assistant Supervisor
- Supervised medical assistant workflows, ensuring smooth patient flow and timely clinical support.
- Trained staff on rooming procedures, vital signs, and electronic health record documentation.
- Coordinated daily schedules, balancing provider needs, patient volume, and back-office coverage.
- Monitored compliance with infection control, HIPAA, and clinical support protocols.
Medical Office Coordinator
- Coordinated patient scheduling, visit changes, and calendar updates for smooth daily office operations.
- Maintained accurate client records, filing systems, and documentation for care coordination needs.
- Communicated with families, caregivers, and clinical staff to resolve scheduling and service questions.
- Processed intake paperwork and verified information for new senior care clients.
- Assisted office team with phone coverage, message routing, and routine administrative tasks.
- Assisted in the recruitment and training of new staff members, contributing to a knowledgeable and professional team.
- Created and maintained medical records from time of admission through patient discharge.
- Processed new office referrals to correct agencies within 24 hours of receiving notice.
- Managed inventory levels effectively, ensuring adequate supplies were available for daily operations without excess waste or cost.
- Pulled charts and prepared for nurse and doctor assessment.
- Entered procedure codes and diagnosis codes into medical billing software.
- Coordinated luncheons with Pharmaceutical Representatives.
- Double-checked forms for accuracy and completion in terms of admission, transfer and discharge of patients.
- Verified benefits and worked with insurance companies to obtain payments.
Education
Medical Assistant - Medical Assistant And Billing
High School Diploma
Skills
Claim submission
Medical billing
Insurance claims processing
Denial management
Payment posting
Medical coding expertise
ICD-10 proficiency
Insurance verification
Medicare processes
Third-party billing
Insurance billing
Medical claims submission
HIPAA compliance
HIPAA certification
Electronic health record software
Medical terminology
Insurance types
Microsoft office
Microsoft office
Timeline
Marysville High
High School Diploma
Read More
Medical Billing Specialist
John Alford
2014 - 2019Read More
Medical Billing Manager
Dr Shwratz
2007 - 2012Read More
Medical Assistant Supervisor
Dr Jay Grassell
2003 - 2008Read More
Medical Office Coordinator
A Better Alternative To Senior Care
2005 - 2007Read More
Cambridge College
Medical Assistant from Medical Assistant And Billing
Read More