Detail-oriented Medical Biller with extensive expertise in medical coding and HIPAA compliance. Demonstrated success in processing claims, securing refunds, and developing accurate billing reports. Recognized for strong interpersonal skills and proficiency in industry-standard billing software. Aiming to leverage skills to enhance operational efficiency within a dynamic healthcare environment.
Overview
4
4
years of professional experience
Work History
Medical Biller/ Payment Poster
Sanford Health Care Center
Remote, SD, USA
11.2023 - 12.2024
Reviewed patient records for accuracy and completeness of information in medical billing system.
Ensured compliance with federal and state regulations relating to medical billing procedures.
Provided training to new employees on proper procedures related to medical billing processes.
Performed data entry of patient information into medical billing system.
Coordinated with billing department to clarify billing issues related to coding.
Utilized ICD-10, CPT, and HCPCS coding systems to process claims and billing.
Analyzed patient charts and records to extract relevant coding information.
Entered coded data into electronic health record (EHR) systems.
Tracked details such as authorizations, pre-certifications or referrals required prior to service delivery.
Reviewed account information to confirm patient and insurance information is accurate and complete.
Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
Utilized coding software and tools efficiently to expedite the coding process.
Reviewed denials received from payers and communicated findings with billing staff.
Assessed billing statements for correct diagnostic codes and identified problems with coding.
Customer Service & Billing Representative
QualDerm Partners, LLC
Remote, TN, USA
11.2022 - 12.2024
Provided timely assistance to customers via phone, email, and live chat channels, ensuring a high level of professionalism at all times.
Managed a high volume of inbound calls while maintaining excellent call quality standards and adhering to established procedures.
Utilized CRM systems effectively to track customer interactions, document detailed case notes, and access relevant account information quickly when needed.
Developed strong relationships with clients, resulting in repeat business and positive feedback.
Researched and resolved billing discrepancies to enable accurate billing.
Monitored customer accounts to identify and rectify billing issues.
Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
Answered telephone calls to offer office information, answer questions, and direct calls to staff.
Organized waiting lists for high-demand services, ensuring timely access for priority cases or cancellations.
Researched and resolved billing issues with customers.
Managed claims processing, billing, and account reconciliations.
Scheduling/Payroll Support Specialist
Jefferson City Health And Rehabilitation
Jefferson City, TN
05.2021 - 11.2022
Served as a knowledgeable resource for employees seeking clarification on payroll-related matters, addressing concerns promptly and professionally.
Collaborated with Human Resources to manage employee data changes, ensuring accurate record-keeping for all personnel.
Prepared detailed reports for management review, highlighting key trends and areas for improvement in the payroll process.
Enhanced payroll accuracy by meticulously reviewing timesheets and resolving discrepancies.
Improved the accuracy of time and attendance data by working closely with managers to address discrepancies and ensure proper documentation was submitted.
Increased schedule adherence through consistent monitoring and real-time adjustments as needed.
Collaborated with management to identify staffing needs and allocate resources accordingly, optimizing workforce utilization.
Assisted in employee onboarding by developing comprehensive training schedules tailored to individual learning needs.
Assisted HR department in determining staffing needs by analyzing business growth and seasonal trends, ensuring the right personnel were hired and trained as needed.
Resolved scheduling conflicts promptly, minimizing disruptions to daily operations.
Medical Assistant
Planned Parenthood Of Tennessee
Knoxville, TN
02.2021 - 05.2021
Taught patients about medications, procedures, and care plan instructions.
Sanitized, restocked, and organized exam rooms and medical equipment.
Obtained client medical history, medication information, symptoms, and allergies.
Collected and documented patient medical information such as blood pressure and weight.
Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
Built strong relationships with patients through effective communication skills that foster trust in the clinic''s commitment to quality care.
Documented vital signs and health history for patients in clinic and hospital environments.
Completed clinical procedures and gathered patient data for interpretation by physician.
Called and faxed pharmacies to submit prescriptions and refills.
Education
MBA - Healthcare Management
Purdue University - Global
Remote, IN, USA
01-2026
Bachelor of Science - Healthcare Administration
Purdue University - Global
Remote, Lafayette, IN
04.2025
Skills
Data entry and management
Medical claims coding
Insurance coding (ICD-9 and CPT)
Data Verification
Insurance claims analysis
Inpatient records coding
Medical billing
Healthcare operations
Attention to detail
Data analysis
References
References available upon request.
Timeline
Medical Biller/ Payment Poster
Sanford Health Care Center
11.2023 - 12.2024
Customer Service & Billing Representative
QualDerm Partners, LLC
11.2022 - 12.2024
Scheduling/Payroll Support Specialist
Jefferson City Health And Rehabilitation
05.2021 - 11.2022
Medical Assistant
Planned Parenthood Of Tennessee
02.2021 - 05.2021
MBA - Healthcare Management
Purdue University - Global
Bachelor of Science - Healthcare Administration
Purdue University - Global
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