Heather Wilbourne
Long Grove,IA
Summary
Medical Billing and Coding Specialist with 7 years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes. Hardworking professional applies official coding conventions and rules established by American Medical Association and Centers for Medicare and Medicaid Services. Confident Medical Coder adheres to data confidentiality and privacy rules in all workflows and promotes dynamic interpersonal skills. Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Outpatient Medical Coder
Genesis Health Group
05.2020 - Current
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
Billing Specialist
Heartland Clinic
05.2016 - 05.2019
- Researched and resolved billing discrepancies to enable accurate billing.
- Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
- Monitored customer accounts to identify and rectify billing issues.
- Provided excellent customer service, developing and maintaining client relationships.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Used data entry skills to accurately document and input statements.
- Verified accuracy of accounts payable payments, resulting in 95% reduction in payment errors and check reissues
Internship Student
Genesis Medical Center
08.2016 - 11.2016
- Reported back to instructor to receive day-to-day tasks and responsibilities.
- Communicated effectively with faculty and staff and accepted critiques and suggestions for areas of improvement.
- Sorted, organized, and maintained files.
- Interacted with customers by phone, email, or in-person to provide information.
- Provided clerical support, addressing routine, and special requirements
- Prepared project presentations and reports to assist senior staff
- Maintained accurate records and documentation of projects to inform stakeholders of progress and updates
Assistant Store Manager
Casey's General Stores Inc
08.2012 - 07.2014
- Managed opening and closing procedures and recommended changes to enhance efficiency of daily activities.
- Rotated merchandise and displays to feature new products and promotions.
- Walked through store areas to identify and proactively resolve issues negatively impacting operations.
- Maintained positive customer relationships by responding quickly to customer service inquiries.
- Supervised and evaluated staff to help improve skills, achieve daily objectives, and attain advancement.
- Processed payments for credit and debit cards and returned proper change for cash transactions.
- Reconciled daily sales transactions to balance and log day-to-day revenue.
Education
Bachelor of Science - Health Information Technology
Southern New Hampshire University
Hooksett, NH06.2022
Associate of Science - Health Information Technology
Eastern Iowa Community College District
Davenport, IA05.2016
High School Diploma -
Nodaway Valley High School
Greenfield, IA05.2006
Skills
- Charting and Clinical Documentation
- Clerical Support
- Code Actions
- Coding Error Resolution
- Compensation Research
- Computerized Indexing Systems
- Demographics Information
- Document Quality
- Medical Claims Coding
- Medical Billing and Coding
- Outpatient Procedures
- Procedural Codes
- Protected Health Information
Certification
- RHIT - Registered Health Information Technician
- CCS-P - Certified Coding Specialist - Physician - Based
Timeline
Outpatient Medical Coder
Genesis Health Group
05.2020 - Current
Internship Student
Genesis Medical Center
08.2016 - 11.2016
Billing Specialist
Heartland Clinic
05.2016 - 05.2019
Assistant Store Manager
Casey's General Stores Inc
08.2012 - 07.2014
Bachelor of Science - Health Information Technology
Southern New Hampshire University
Associate of Science - Health Information Technology
Eastern Iowa Community College District
High School Diploma -
Nodaway Valley High School
Similar Profiles
Susan DibbernSusan Dibbern
Specalist,Patient Accounts at Genesis Health GroupSpecalist,Patient Accounts at Genesis Health Group
Danelle GreenDanelle Green
Sonographer at Genesis Medical Center DeWittSonographer at Genesis Medical Center DeWitt
Katrel WilsonKatrel Wilson
LPN Office Nurse at Metro Inclusive HealthLPN Office Nurse at Metro Inclusive Health
Shawn SmithShawn Smith
Stay at Home Parent at Self-employeedStay at Home Parent at Self-employeed
Lance BellLance Bell
Roads Superintendent at Scott County Secondary RoadsRoads Superintendent at Scott County Secondary Roads