Barbara L. Vaughn
Columbus,OH
Summary
Motivated medical billing and coding specialist with over twenty years of experience in healthcare management operations, billing, coding and accounts receivable. Highly skilled in analyzing and validating patient information, diagnoses, posting patient and insurance remittance, and billing data. Demonstrated leader and team-member who is capable of processing high volumes of patient information to achieve revenue generation goals.
Obtain a permanent full-time position as an Accounts Receivable Specialist or Medical Billing and Coding Specialist in a professional office setting, where providing superior customer service and supporting clients is the organization’s top priority.
Overview
10
10
years of professional experience
Work History
Medical Billing Specialist
Primary One Health
02.2024 - 07.2025
- Temporary employee for first 90-days, selected over several others candidates to become a permanent hire
- Chosen as the go-to person for management in crisis situations; and served a trainer for new employees in billing operations
- Performed error free billing and collections from multiple payer sources
- Reviewed claims for completeness and accuracy before claims were released
- Served as customer service liaison and answered billing questions
- Researched and made corrections to denial of claims
- Documented correspondence with patients, insurance carriers, and providers
- Retrieved patient and insurance payment remittance in a clinical setting and posted daily and monthly balances
- Updated or corrected patient insurance coverage for proper billing of claims
- Helped business associates with questions
- Received a 5 percent merit-based pay increase during first six months of employment
- Awarded a second 2 percent merit-based pay raise on 1 June 2025; based on superior work performance, initiative, leadership and team-work
- Due to extensive knowledge of medical billing selected to work on special projects with high visibility and short timelines for execution
Medical Billing Specialist
Specialized Medical Billing
10.2021 - 09.2023
- Performs as manager/team lead in Medical Billing supervisors’ absence.
- Based on experience and expertise chosen by the management team to train new hire billing specialists.
- Collected, posted, and managed patient account payments, and prepared and submitted claims forms to insurance companies and other third-party payers.
- Performed insurance verification, pre-certification, and pre-authorization.
- Entered procedure and diagnosis codes and requisite patient information into billing software to streamline invoicing and account management; added modifiers, verified diagnoses, and coded narrative diagnoses.
- Reviewed and validated accuracy of charges, including dates of service, services provided, location, patient identification, and provider signature.
- Used electronic capture practices such as billing and account receivables (BAR) system and medical billing clearinghouse accounts to submit codes and invoices on-time.
- Responded to staff and client inquiries regarding CPT and diagnosis codes.
- Communicated with patients and healthcare providers for verification of billing information.
- Process routine claims, investigate pending claims and resolve discrepancies, and submitted appeals.
- Receive, process, post, transfer payments to patient’s accounts and correct insurance posting payments as needed.
- Routinely exceeded hourly production quotas.
- Uphold and reinforce compliance with hospital policies and federal regulations such as HIPAA.
Medical Claims Analyst
HealthScope Benefits/United Health
02.2015 - 01.2021
- Based on demonstrated proficiency chosen by management to train new hire claims analysts.
- Maintained a comprehensive understanding of laws and guidelines concerning medical claims.
- Collected and processed requisite information to complete medical insurance claims.
- Analyzed each claim to ensure compliance with requisite guidelines and procedures.
- Was responsible for maintaining and ensuring claims archive was accessible.
- Created monthly reports for management on financial status of outstanding and paid claims.
- Processed routine claims, investigated pending claims and resolved discrepancies.
- Received and immediately processed government medical claims to ensure prompt payment.
- Scanned new claims into the computer system for archiving purposes.
- Contacted patients and healthcare providers for verification of claims.
- Remained current on explanation of benefits.
- Routinely exceeded hourly processing quotas.
Education
Associate of Arts - Healthcare Administration, Medical Billing & Coding
University of Phoenix
Phoenix, AZ01.2012
Administrative Assistance Program - undefined
Eastland Career Center
Groveport, OH01.1991
Skills
- Expert in ICD-10, HMO, PPO, CPT and HCPCS (Medicare and Medicaid) coding
- Extensive experience in Operations Management, Quality Assurance, Medical Billing, Medical Records Management, Accounts Receivable, and Patient Confidentiality (HIPAA Compliance)
- Proficient with Availity, Exscribe, NexExtender, PHP, Priority, Department of Labor, and other insurance portals
- Medical Management experience including medical accounting, filing, and charting
- Skilled usage of Microsoft Office Suite, Medisoft and Electronic Health Records (EHR)
- Excellent interpersonal, oral and written communication skills, thrives on solving complex problems in fast paced work environment
- Trained in the operation and use of all common office equipment
- Skilled in office workplace settings or work-from-home environment
Timeline
Medical Billing Specialist
Primary One Health
02.2024 - 07.2025
Medical Billing Specialist
Specialized Medical Billing
10.2021 - 09.2023
Medical Claims Analyst
HealthScope Benefits/United Health
02.2015 - 01.2021
Administrative Assistance Program - undefined
Eastland Career Center
Associate of Arts - Healthcare Administration, Medical Billing & Coding
University of Phoenix