HEATHER DAWN THAMES
Crystal River,FL
Summary
Adept Medical Billing Specialist with a proven track record at Surgery Partners, enhancing billing processes and ensuring HIPAA compliance. Mastered billing and insurance regulations, significantly improving claim accuracy. Excelled in team collaboration and customer service, while proficient in Microsoft Excel and Nextgen. Achieved notable efficiency in resolving billing issues, demonstrating strong organizational and active listening skills. Accomplished individual with a comprehensive understanding of medical coding, billing and claims procedures. Experienced in using various medical billing software and databases. Proven track record of successfully resolving billing disputes and providing accurate and timely billing solutions. Committed to delivering exceptional customer service and building long-term relationships with clients.
Competent Medical Billing Specialist with 30+ 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
11
11
years of professional experience
Work History
Medical Billing Specialist
Surgery Partners
Tampa, FL
06.2015 - Current
- Utilized electronic billing systems to submit claims to insurance providers in a timely manner.
- Processed medical bills and insurance claims accurately, ensuring compliance with HIPAA regulations.
- Protected confidentiality of sensitive information to comply with HIPAA guidelines.
- Verified accuracy of patient information, including demographic data and insurance coverage details.
- Resolved patient billing issues and communicated with insurance carriers.
- Prepared and reviewed claims for submission, resolving upfront claims edits and errors.
- Collaborated with healthcare providers and office staff on billing issues as necessary.
- Reviewed and evaluated unpaid claims to determine cause of delay or denial, taking appropriate action as needed.
- Developed detailed knowledge of CPT coding system, insurance regulations, and medical terminology.
- Entered billing information into accounting software systems.
- Analyzed trends in denials and rejections of medical bills to identify areas for improvement in billing process.
- Entered all relevant patient information into the practice management software system accurately and efficiently.
- Verified accuracy of billing data and revised any errors.
- Assisted with training new employees on medical billing practices, procedures, and protocols.
- Generated monthly financial reports and statements for management review.
- Operated typing, adding, calculating, and billing machines.
- Reviewed patient accounts for accuracy before submission, reducing errors by implementing quality control measures.
- Processed medical claims efficiently, ensuring compliance with payer guidelines and regulations.
- Analyzed billing discrepancies to resolve issues and enhance accuracy in billing submissions.
- Trained new staff on billing software and compliance standards, fostering a knowledgeable team environment.
Education
High School Diploma -
Darsey Private
Albany, GASkills
- Strong organizational skills
- Conflict resolution
- Energetic work attitude
- Adaptive team player
- Active listening skills
- Courteous demeanor
- Customer service
- Claim submission
- Insurance verification
- Patient billing
- Accounts payable
- Collections management
- Insurance billing
- Data entry
- Medical billing
- Insurance claims
- Claims review
- Billing and collection procedures
- Insurance claims processing
- Critical thinking
- Electronic claims
- Teamwork and collaboration
- CMS-1500 billing forms
- Accounts receivable
- Medical claims submission
Timeline
Medical Billing Specialist
Surgery Partners
06.2015 - Current
High School Diploma -
Darsey Private
Training
- Microsoft Excel
- Word
- Outlook
- Windows Programs
- Nextgen
- Amicas
- NHXS
- Navinet
- Rislinq
- Astri
- Zirmed
- Source Rad
- Availity
- Med Evolve
- ECeno
- Medtrax 2.1
- Imagine V-10
- Athena