Caitlin Swinford
Fountain Hills,AZ
Summary
Competent Medical Biller with 15 years of experience in handling wide variety of medical coding and billing tasks. Sophisticated and hardworking individual with excellent analytical and multitasking abilities. Coordinates with insurance companies and expedites claims processes. Expertise in accurately inputting procedure and diagnosis codes into billing software to generate invoices.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Medical Biller
Agave Pediatrics
01.2008 - Current
- Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
- Acted as liaison between healthcare providers and insurance companies; resolved disputes quickly while maintaining positive relationships.
- Entered invoices requiring payment and disbursed amounts via check, electronic transfer or bank draft.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Negotiated favorable payment terms with third-party payers, improving overall revenue collection rates.
- Trained new team members in medical billing software, increasing efficiency within the department.
- Handled account payments and provided information regarding outstanding balances.
- Liaised between patients, insurance companies, and billing office.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Resolved discrepancies in accounts receivable reports, contributing to improved cash flow management.
- Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
- Delivered timely and accurate charge submissions.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Collaborated with customers to resolve disputes.
- Generated monthly billing and posting reports for management review.
- Streamlined billing processes by implementing efficient procedures to improve accuracy and reduce errors.
- Monitored outstanding invoices and performed collections duties.
- Processed vendor and supplier payments on weekly basis.
- Used data entry skills to accurately document and input statements.
- Audited and corrected billing and posting documents for accuracy.
- Collaborated with healthcare providers, ensuring accurate documentation for seamless billing operations.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Conducted regular audits of billing records to ensure accuracy and completeness, enhancing overall financial performance for the practice.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Established strong relationships with insurance representatives, facilitating prompt resolution of billing issues.
- Posted payments and collections on regular basis.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Generated accounts payable reports for management review to aid in financial and business decision making.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Excellent communication skills, both verbal and written.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
- Managed time efficiently in order to complete all tasks within deadlines.
- Gained extensive knowledge in data entry, analysis and reporting.
- Demonstrated strong organizational and time management skills while managing multiple projects.
Education
No Degree - Medical Insurance Billing
Carrington College - Phoenix
Phoenix, AZ01.2008
Skills
- Payment Collection
- Electronic Claims
- Accounts receivable management
- Discrepancy Reconciliation
- Expense Tracking
- Statement preparation
- Commercial and Private Insurance
- A/P and A/R expertise
- Insurance Billing
- Medical Billing
- Payment posting
- Claims Processing
- Claim submission
- Claims review
Certification
- Medical Billing Training - 15 years
Timeline
Medical Biller
Agave Pediatrics
01.2008 - Current
No Degree - Medical Insurance Billing
Carrington College - Phoenix
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