Skilled and detail-oriented medical billing professional with experience in claims processing, insurance verification, CPT/ICD-10 coding, and denial resolution.
Overview
37
37
years of professional experience
Work History
Medical Biller
MBI of Delaware Valley
Philadelphia, PA
06.2021 - Current
Verified insurance coverage and secured required prior authorizations.
Submitted and tracked professional medical claims through electronic billing systems.
Posted payments, adjustments, and contractual write-offs to patient accounts.
Monitored aging A/R and prioritized accounts needing follow-up.
Investigated claim denials and corrected billing errors to improve reimbursement.
Reviewed CPT and ICD-10 codes for billing accuracy and identified discrepancies for correction.
Assisted with month-end reports.
Sent monthly patient statements.
Assisted patients with questions regarding statement balances.
Protected patient information in accordance with HIPAA policies.
Prior Authorization Specialist
Philadelphia Heart, PC
Philadelphia, PA
07.2017 - 05.2021
Contacted insurance carriers to secure prior authorization for upcoming tests and procedures.
Provided accurate information to patients, insurance carriers, and office staff.
Maintained referral and insurance files and entered referrals into system.
Submitted procedure and diagnosis codes to insurance carriers.
Reviewed patient insurance coverage to determine liability for co-payments on medical services.
Surgery Scheduler
Urology Consultants
Philadelphia, PA
05.2012 - 07.2017
Scheduled urology surgeries with patients during checkout and reviewed pre-op instructions and appointment details.
Prepared patient charts and surgical packets for urology procedures.
Collected required documents before scheduled procedures.
Assisted with pre-operative preparation by obtaining insurance authorizations, lab work, and radiology tests.
Customer Service Representative
Samuels and Son Seafood
Philadelphia, PA
02.2005 - 09.2007
Managed wholesale seafood orders for Samuels and Son Seafood customers.
Entered purchase requests into order system with accuracy.
Answered customer calls about product availability and delivery schedules.
Documentation Specialist
Wachovia Bank
Philadelphia, PA
07.2001 - 11.2003
Maintained secure customer records for files and regulatory audits.
Updated technical document logs to reflect all revisions made.
Supported secure backup storage and retrieval of archived documents.
Accounts Assistant
Eastern Distributors
Philadelphia, PA
09.1989 - 06.2001
Managed vendor relations through timely invoice payments and resolving any outstanding payment disputes.
Verified and processed invoices from vendors and contacted suppliers regarding billing errors.
Prepared and processed invoices, payments and bank deposits.
Processed invoices and matched documents for Eastern Distributors accounts records.