Christine Clemmons
Medical Billing
Rosharon,TX
Summary
Reliable Medical Biller with coding and medical terminology knowledge. Polished and hardworking performer with background overseeing accounts and handling records management tasks. Team-oriented person with great decision-making skills.
Overview
12
12
years of professional experience
3
3
years of post-secondary education
Work History
Medical Billing Specialist
Comprehensive Healthcare Solutions
Houston, TX
02.2022 - Current
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Filed and updated patient information and medical records.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Maintained and updated collections tracking spreadsheet to help organize payment information.
- Located errors and promptly refiled rejected claims.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Identified and resolved patient billing and payment issues.
Medical Billing Consultant
Nielson Financial Services
Houston, TX
01.2020 - 03.2022
- Adhered to established standards to safeguard patients' health information.
- Completed monthly billing for all Medicaid and Commercial payers.
- Completed end of month duties including triple check with the nursing facility department heads.
- Liaised between patients, insurance companies, and billing office.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Posted payments and collections on regular basis.
- Collected payments and applied to patient accounts.
- Filed and updated patient information and medical records.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Verified insurance of patients to determine eligibility.
- Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
- Generated monthly billing and posting reports for management review.
- Monitored outstanding invoices and performed collections duties.
- Handled account payments and provided information regarding outstanding balances.
- Audited and corrected billing and posting documents for accuracy.
- Used data entry skills to accurately document and input statements.
- Obtained necessary prior authorizations for the incoming patient's in need of admission to the skilled nursing facility.
Medical Billing Specialist
Sava Senior Services
Houston, TX
09.2017 - 01.2020
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Maintained and updated collections tracking spreadsheet to help organize payment information.
- Located errors and promptly refiled rejected claims.
- Responsible for monthly billing of all payers including Medicare, Medicaid and Commercial policies
Medical Billing Specialist
Interim Healthcare
Houston, TX
05.2017 - 08.2017
- Liaised between patients, insurance companies, and billing office.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Filed and updated patient information and medical records.
- Precisely evaluated and verified benefits and eligibility.
- Evaluated patients' financial status and established appropriate payment plans.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
Medical Billing and Collections Specialist
Altus Hospice
Pearland, TX
07.2015 - 05.2017
- Processed online and paper appeal submissions and refund requests.
- Completed bi-weekly and monthly billing on all Medicare and Medicaid payers.
- Logged charges and payments.
- Corrected, completed and processed claims for multiple payer codes.
- Generated accounts payable reports for management review to aid in financial and business decision making.
- Generated monthly billing and posting reports for management review.
- Used data entry skills to accurately document and input statements.
- Audited and corrected billing and posting documents for accuracy.
- Collaborated with customers to resolve disputes.
- Monitored outstanding invoices and performed collections duties.
- Handled account payments and provided information regarding outstanding balances.
Reimbursement Specialist
Altus Medical Equipment
Pearland, TX
05.2014 - 07.2015
- Built proactive, client-specific edits into system to prevent future denials.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
- Processed online and paper appeal submissions and refund requests.
- Corrected, completed and processed claims for multiple payer codes.
- Processed billing calls and answered questions from patients and third-party carriers.
Front Desk Specialist
Houston Allergy And Asthma Associates
Webster, TX
07.2013 - 05.2014
- Collect and document payments from patients following their visit.
- Perform insurance verification to report the proper insurance payment and potential payment on procedures.
- Complete documentation to properly file the medical claims.
- Phone reception and fielding of all incoming calls.
- Appointment verification for all upcoming appointments.
Respiratory Customer Service
Medical Plus Supplies
Houston, TX
08.2011 - 07.2013
- Completed insurance verification for all payers including Medicare, Medicaid and Commerical policies.
- Obtained proper authorizations for the services requested.
- Review medical records to ensure the request for medical equipment from the physician is able to be completed.
- Spoke with patient's and their family concerning their portion of payment for the needed medical equipment.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Participated in team meetings and training sessions to stay informed about product updates and changes.
Education
Associate of Arts - Behavioral And Social Services
San Jacinto College
Houston, TX 01.2014 - 12.2016
Skills
Medicare and Medicaid process
Payment posting
Medical record security
Accounts receivable management
Collection calls
Medical claims submission
Patient account analysis
Medical coding knowledge
Data analysis
Collections duties
Billing statement review
Skilled Nursing Facility Experience
Hospice Experience
Timeline
Medical Billing Specialist
Comprehensive Healthcare Solutions
02.2022 - Current
Medical Billing Consultant
Nielson Financial Services
01.2020 - 03.2022
Medical Billing Specialist
Sava Senior Services
09.2017 - 01.2020
Medical Billing Specialist
Interim Healthcare
05.2017 - 08.2017
Medical Billing and Collections Specialist
Altus Hospice
07.2015 - 05.2017
Reimbursement Specialist
Altus Medical Equipment
05.2014 - 07.2015
Associate of Arts - Behavioral And Social Services
San Jacinto College
01.2014 - 12.2016
Front Desk Specialist
Houston Allergy And Asthma Associates
07.2013 - 05.2014
Respiratory Customer Service
Medical Plus Supplies
08.2011 - 07.2013