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
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