Ashley Swinney
Burleson
Summary
Medical Coding and Billing Specialist dependable, dedicated, hardworking and good with patient care, with multi-tasking skills; seeking an opportunity in your office to contribute to the betterment of patients and the success of the office.
Qualified Biller with strong background in medical billing and claims processing. Effectively managed accounts receivable and resolved discrepancies to ensure timely payments. Demonstrated expertise in utilizing billing software and maintaining accurate patient records.
Overview
3
3
years of professional experience
1
1
Certification
Work History
DME BILLER, PRE AUTH, DENIALS
Lone Star Orthopaedic & Spine Specialist
07.2024 - Current
- Processed and verified medical billing claims for accuracy and compliance with regulations.
- Managed patient accounts, ensuring timely resolution of billing inquiries and discrepancies.
- Collaborated with healthcare providers to obtain necessary documentation for insurance claims.
- Resolved coding errors by liaising with coders, resulting in faster claim approvals.
- Checked insurance eligibility by making appropriate phone calls and conducting research on services rendered.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Determined proper codes for medical records and patient services.
- Provided exceptional customer service in handling billing inquiries, resolving disputes promptly and professionally.
- Followed up with appropriate parties to obtain prompt payments.
- Evaluated patient medical records to determine eligibility for pre-authorization of procedures and services.
- Communicated with healthcare providers to gather necessary documentation for approval processes.
- Coordinated with insurance companies to facilitate timely authorizations and resolve discrepancies.
- Monitored compliance with regulatory requirements in all pre-authorization requests.
Medical Biller
Cardiology Partners
02.2023 - 03.2025
- Processed medical claims using industry-standard billing software for accurate reimbursements.
- Reviewed patient records to ensure compliance with insurance requirements and billing policies.
- Communicated with healthcare providers and patients regarding billing inquiries and payment options.
- Resolved discrepancies in billing statements through detailed investigation and documentation.
- Maintained up-to-date knowledge of coding systems, including ICD-10 and CPT codes, for accurate claim submissions.
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Filed and updated patient information and medical records.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Collected payments and applied to patient accounts.
- Posted payments and collections on regular basis.
AR Specialist
Ventra Health
06.2022 - 01.2023
- Worked in an office environment, answering phone calls, putting in patient information, taking payments, as well as calling and handling health insurance request, sending off claims, and appeals.
Education
Medical Coding and Billing Specialist -
The College of Health Care Professions
Fort Worth, TX06.2022
Skills
- Billing
- Coding
- Collection/Reimbursements
- Dispute resolution
- Billing systems and software
- Claim submission
- Month-end closing procedures
- Billing dispute resolution
- Multitasking Abilities
- Insurance billing procedures
- ICD-10, CPT & HCPCS
- HIPAA Compliance
- Insurance Verifications
- Charting
- Documentation
- Eligibility Benefits
- Referrals/Prior Authorization
- Electronic Health Records (EHR)
- Health Information Management
- Insurance Billing
- Medical Terminology
Certification
- American Heart Association BLS for Healthcare Providers (CPR) Certification 2022-03-03
- National Association of Healthcare Professionals Nationally Registered Coding Specialist 2022-06
Timeline
DME BILLER, PRE AUTH, DENIALS
Lone Star Orthopaedic & Spine Specialist
07.2024 - Current
Medical Biller
Cardiology Partners
02.2023 - 03.2025
AR Specialist
Ventra Health
06.2022 - 01.2023
Medical Coding and Billing Specialist -
The College of Health Care Professions
NATIONAL ASSOCIATION FOR HEALTH PROFESSIONALS ICD 10 CERTIFIED
CERTIFIED ICD 10 CODING SPECIALIST
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