Jane Johnson
Berthoud,CO
Summary
Dynamic Medical Billing Specialist with extensive experience at SCL Health System, adept at optimizing revenue cycle management and enhancing patient satisfaction. Proficient in claims submission and denial management, I excel in resolving billing discrepancies while delivering exceptional customer service. A quality-oriented team player, I leverage my expertise in CPT coding to drive efficiency and accuracy.
Driven Medical Biller motivated to perform beyond expectations.
Overview
18
18
years of professional experience
Work History
Medical Billing Specialist
Med-Metrix
Berthoud, CO
09.2022 - 03.2026
- Processed medical claims with accuracy, ensuring timely submissions to insurance providers.
- Resolved billing discrepancies, enhancing patient satisfaction and minimizing payment delays.
- Verified patient insurance information to maintain compliance with healthcare regulations.
- Collaborated with healthcare providers to gather necessary documentation for claim processing.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Located errors and promptly refiled rejected claims.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Precisely evaluated and verified benefits and eligibility.
- Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
Medical Billing Specialist
SCL Health System
Berthoud, CO
08.2016 - 07.2021
- Conducted audits of billing procedures, identifying areas for process improvements and efficiency gains.
- Trained new staff on billing software and industry best practices, fostering team development.
- Implemented tracking systems for outstanding claims, improving follow-up procedures and reducing aged accounts receivable.
- Analyzed billing trends to develop strategies for reducing errors and optimizing revenue cycle management.
- Identified and resolved patient billing and payment issues.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Filed and updated patient information and medical records.
- Liaised between patients, insurance companies, and billing office.
- Participated in departmental meetings, sharing insights and ideas for improving overall medical billing efficiency and revenue generation.
- Monitored changes in payer requirements, adjusting billing practices accordingly to minimize disruptions in the revenue cycle.
- Continuously updated knowledge of industry regulations and compliance requirements, ensuring adherence to all applicable standards.
- Increased overall efficiency of the billing department by regularly auditing internal procedures and suggesting improvements.
- Verified insurance of patients to determine eligibility.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Responded to customer concerns and questions on daily basis.
- Resolved billing discrepancies, enhancing patient satisfaction and minimizing payment delays.
- Verified patient insurance information to maintain compliance with healthcare regulations.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
- Precisely evaluated and verified benefits and eligibility.
Medical Billing Specialist
Rockwood
Spokane, WA
07.2008 - 05.2015
- Posted and adjusted payments from insurance companies.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
- Served as a subject matter expert on medical billing matters, providing guidance to colleagues on complex cases or unique situations.
- Efficiently processed refunds or adjustments for patients when necessary, ensuring accuracy and compliance with company policies.
- Reduced errors in medical billing by meticulously reviewing patient records and ensuring accurate coding.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Adhered to established standards to safeguard patients' health information.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Collaborated with customers to resolve disputes.
- Audited and corrected billing and posting documents for accuracy.
- Maintained accurate records of customer payments.
- Handled account payments and provided information regarding outstanding balances.
- Verified accuracy of accounts payable payments, resulting in [Number]% reduction in payment errors and check reissues.
- Processed medical claims with accuracy, ensuring timely submissions to insurance providers.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Trained new staff on billing software and industry best practices, fostering team development.
- Analyzed billing trends to develop strategies for reducing errors and optimizing revenue cycle management.
- Identified and resolved patient billing and payment issues.
- Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Filed and updated patient information and medical records.
- Liaised between patients, insurance companies, and billing office.
- Participated in departmental meetings, sharing insights and ideas for improving overall medical billing efficiency and revenue generation.
- Continuously updated knowledge of industry regulations and compliance requirements, ensuring adherence to all applicable standards.
- Verified insurance of patients to determine eligibility.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Responded to customer concerns and questions on daily basis.
- Resolved billing discrepancies, enhancing patient satisfaction and minimizing payment delays.
- Verified patient insurance information to maintain compliance with healthcare regulations.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
- Precisely evaluated and verified benefits and eligibility.
Education
Associate of Science - Medical Billing
Valley Business College
Lewiston, ID05.1998
Skills
- HIPAA compliance
- Payment posting
- Claim submission
- Insurance verification
- Patient billing
- CPT knowledge
- Denial management
- Medicare and medicaid process
- Collections management
- Quality-oriented team player
- EPIC software applications proficiency
- Insurance billing
- Data entry
- Medical billing
- Insurance claims
- Medical terminology
- Claims review
- Billing and collection procedures
- Insurance claims processing
- Critical thinking
- Customer service
- Electronic claims
- Teamwork and collaboration
- CMS-1500 billing forms
- Medical claims submission
- Patient collections
- Account reconciliation
- Commercial and private insurance
- Multitasking and organization
- Knowledgeable in EPIC
- Work prioritization
- Medical terminology expert
- Account management
- EPIC use
- 104 WPM
- Medical transcription
- Verbal and written communication
- CPT code modifiers
- Reimbursements
- Database systems
- Medical billing technology
Timeline
Medical Billing Specialist
Med-Metrix
09.2022 - 03.2026
Medical Billing Specialist
SCL Health System
08.2016 - 07.2021
Medical Billing Specialist
Rockwood
07.2008 - 05.2015
Associate of Science - Medical Billing
Valley Business College