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Summary
Overview
Work History
Education
Skills
Timeline
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Amber Pendleton

Hartselle,AL

Work Preference

Job Search Status

Open to work
Desired start date: Immediately

Desired Job Title

Insurance SpecialistBiller/Billing ManagerManaged Care SpecialistCollector II/ Escalation RepresentativeMedical Biller

Work Type

Full Time

Location Preference

RemoteOn-SiteHybrid
Location: Hartselle, AL, USHartselle, AL
Open to relocation: No

Important To Me

Career advancementWork-life balanceCompany CultureFlexible work hoursPersonal development programsWork from home optionPaid time offPaid sick leave

Summary

Driven professional with prior supervisory experience in office administration, strategic planning, billing services, accounts payables, insurance claims, and customer service in healthcare and law sectors. Self-starter equipped with integrity, solid communications skills, superior organizational and leadership skills, as well as creative problem resolution techniques to achieve goals with consistency. Self-motivated Specialist who promotes sustainability of operations by working independently or collaboratively with teams to produce results with lasting impact on the organization.

Experienced Medical Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 18 years of experience and willingness to take on any challenge.

Overview

18
18
years of professional experience
4
4
years of post-secondary education

Work History

Insurance Specialist

Cullman Regional Medical Center
Cullman, AL
06.2024 - 04.2025
  • Follow up for Medicaid, as well as other insurance as needed.
  • Assisted in pre-registration when needed.
  • Processed insurance claims efficiently, ensuring accuracy and compliance with healthcare regulations.

Biller/Billing Manager

North Alabama OB-GYN Associates
Madison, AL
04.2022 - 04.2024
  • Run the day-to-day operations of the billing portion of the practice. Teach and train new employees.
  • Help with billing when and where needed.
  • Bill claims out through the Veradigm system.
  • Code CPT and ICD-10 for surgeries and deliveries.
  • Bill everyday charges.
  • Work with Members of the Verdigm team to ensure needs are being met.
  • Work A/R follow up.
  • Supervise a team of 4 billers to ensure they are meeting goals.

Managed Care Specialist

Huntsville Hospital Health System
Huntsville, AL
07.2019 - 04.2022
  • Assist with the integrity of the credentialing and contracting processes and help ensure that hospital complies with insurance policies.
  • Liaise for the hospital and various insurance companies to resolve contracting and credentialing issues.
  • Organize, review, and ensure the distribution of reports to internal department heads and senior supervisory management.
  • In-charge of various projects, including changeover of contracts and credentials.
  • Provide assistance in the contract loading of two hospitals into a new contract management system.
  • Establish and maintain a solid professional working relationship with insurance providers and customers.
  • Utilized monitoring tools such as key performance indicators to collect data and promote process improvement.

Collector II/ Escalation Representative

Huntsville Hospital Health System
Huntsville, AL
08.2017 - 08.2019
  • Liaised between insurance companies and the Huntsville Hospital Health Systems to facilitate the collection of payments.
  • Assisted non-government manager and quality assurance team to identify insurance issue logs and other payer problems, ensuring immediate resolution of all pending issues while maintaining data integrity.
  • Provided coaching, knowledge transfer, and supervised collection teams to ensure they interact with clients in a professional manner as well as deliver top-quality customer service.
  • Conducted follow up on various A/R accounts across five hospitals within the health system and carried out audits in complicated and atypical accounts receivables, ensuring placement of internal controls adhering to regulatory policies.
  • Ensure HIPAA compliance maintained by following standard privacy practices for both electronic and written communications.

Medical Biller

My Practice Billing
Decatur, AL
02.2017 - 07.2017
  • Fulfilled multiple tasks, including working accounts receivables, defining coding methods based on physician's notation, billing out claims to insurance companies, and ensuring compliance with regulatory laws on data privacy.
  • Analyzed and corrected claims that rejected from insurance with appropriate codes and modifiers.
  • Coordinated with insurance companies to obtain pre-authorization approvals for specific procedures.
  • Entered payment vouchers and insurance rejections from all payer sources into the company system.

Credentialing Specialist/ Medical Biller

Physician Business Solutions
Decatur, AL
01.2014 - 02.2017
  • Supervised regulatory credentialing strategy for end-users of Physician Business Solutions for their healthcare billing and office needs.
  • Credentialed medical staff, including physicians, nurses, and physician assistants, with various insurance companies.
  • Maintained 40+ provider credentialing files while administering all accounts receivables aspects of four companies.
  • Served as a system administrator and used Intergy software to manage financial transactions, including entering appropriate charges to service providers, working accounts receivables, and sending out actual billings.
  • Collaborated with both patients and physician offices to mediate and resolve any billing and insurance issues, ensuring fast issue resolution or escalate to supervisor if the issue remains unsolved.

Administrative Manager

Samaritan Emergency Medical Services
Union Grove, AL
03.2008 - 12.2013
  • Managed business office operations, and ensured 25+ employees of a healthcare ambulance service unit were equipped with necessary business operation materials, allowing the staff to give urgent medical assistance to residents in different counties.
  • Promoted sustainability of operations by conducting thorough audits and ensuring compliance with regulatory guidelines.
  • Implemented effective revenue management, financial analyses, and other strategic initiatives to comb through billing claims, accounts receivables, and posting payments to successfully transform the financial performance of the company from having $100K+ in debt to operating debt-free.
  • Billed insurance companies and private individuals for services rendered by ambulance staff on time.
  • Conducted regular follow up on unpaid claims to reduce claims processing backlog in the revenue cycle.

Education

Bachelor of Arts - History

Athens State University
Athens, AL
09.1994 - 03.1996

J.D. - Law

University of Mississippi
University, MS
08.1996 - 05.1999

Skills

  • Office Administration
  • Accounting Systems
  • Accounts Receivables
  • Research
  • Medical Credentialing
  • Medical Billing Claims Processing
  • Quality Assurance
  • Analytical & Critical Thinking
  • Strategic Planning
  • Regulations Compliance
  • HIPAA Compliance
  • Privacy Compliance
  • Documentation skills
  • Reporting skills
  • Account management
  • Claims management

Timeline

Insurance Specialist

Cullman Regional Medical Center
06.2024 - 04.2025

Biller/Billing Manager

North Alabama OB-GYN Associates
04.2022 - 04.2024

Managed Care Specialist

Huntsville Hospital Health System
07.2019 - 04.2022

Collector II/ Escalation Representative

Huntsville Hospital Health System
08.2017 - 08.2019

Medical Biller

My Practice Billing
02.2017 - 07.2017

Credentialing Specialist/ Medical Biller

Physician Business Solutions
01.2014 - 02.2017

Administrative Manager

Samaritan Emergency Medical Services
03.2008 - 12.2013

J.D. - Law

University of Mississippi
08.1996 - 05.1999

Bachelor of Arts - History

Athens State University
09.1994 - 03.1996
Amber Pendleton