Highly motivated and focused individual with a professional attitude. Favorably organized, accurate, and well versed in the medical field. Experienced in delivering exceptional patient care and customer service. Deliver compassionate and culturally sensitive care to diverse populations. Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information. Competent medical billing professional manages busy medical office and delivers excellent customer service to patients. Organized Medical Biller skilled at accurately auditing patient charts and billing corresponding parties.
Overview
16
16
years of professional experience
Work History
Medical Billing Specialist
Retinal consultants medical group
03.2018 - 09.2024
Processed and submitted medical claims to insurance companies, ensuring accuracy and adherence to billing guidelines
Verified patient information, reviewed medical documentation, followed up on unpaid claims, and maintained updated knowledge of medical coding systems.
Posted and adjusted payments from insurance companies.
Communicated with insurance providers to resolve denied claims and resubmitted.
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.
Located errors and promptly refiled rejected claims.
Identified and resolved patient billing and payment issues.
Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
Collaborated closely with the clinical team to ensure proper documentation was obtained for accurate billing purposes.
Increased overall efficiency of the billing department by regularly auditing internal procedures and suggesting improvements.
Educated colleagues on best practices in medical billing, providing ongoing training sessions as needed.
Verified insurance of patients to determine eligibility.
Reviewed patient records, identified medical codes, and created invoices for billing purposes.
Prepared billing statements for patients and verified correct diagnostic coding.
Delivered timely and accurate charge submissions.
Utilized various software programs to process customer payments.
Used data entry skills to accurately document and input statements.
Maintained accurate records of customer payments.
Managed high-stress situations with professionalism, ensuring that appeals were handled promptly and accurately even under tight deadlines or heavy caseloads.
Consistently met or exceeded performance metrics, demonstrating a strong understanding of the claims review process and an unwavering commitment to achieving positive results for clients.
Maintained high levels of accuracy in all written correspondence, ensuring clear communication with relevant stakeholders during the appeals process.
Educated clients on their rights and responsibilities throughout the appeals process, ensuring a clear understanding of expectations and potential outcomes.
Regularly received commendations from supervisors for demonstrating exceptional commitment to customer service and dedication to client satisfaction throughout the appeals process.
Front office Supervisor
Center for Interventional Spine
12.2015 - 12.2017
Responsible for organizing supplies and equipment, ensuring employees follow protocols, serving as a role model, and de-escalating patient issues.
Trained new front office staff, ensuring thorough understanding of hotel policies and procedures.
Developed strong relationships with repeat customers through personalized service and attention to detail in meeting their needs.
Conducted regular performance evaluations for front office staff to foster professional growth and development opportunities.
Promoted positive work environment by fostering teamwork among front office staff members.
Assisted staff with troubleshooting and resolution of software and hardware issues to minimize downtime.
Maintained accurate financial records, including daily reports on sales transactions, cash drawer balances, and room charges.
Achieved high-quality service by maintaining open communication channels among team members.
Assisted guests with special requests, demonstrating excellent problem-solving skills and a commitment to customer satisfaction.
Established and updated work schedules to account for changing staff levels and expected workloads.
Collaborated with housekeeping and maintenance teams to ensure room availability and quality standards were met.
Lead Medication Tech
Carlton Plaza
07.2014 - 01.2016
Managed medications for residents, communicated with pharmacies and family members, and oversaw staff to ensure proper medication dosing.
Facilitated seamless transitions between shifts by providing thorough handoff reports to incoming staff members.
Ensured proper medication storage and inventory management for optimal efficiency and compliance with regulations.
Educated patients about potential side effects, interactions, and precautions related to their medications.
Monitored patients for adverse reactions or complications from medications, initiating prompt interventions when necessary.
Reduced medication errors by implementing a double-check system for high-risk drugs.
Contributed significantly towards maintaining Joint Commission accreditation by adhering strictly to regulatory guidelines.
Enhanced patient care by accurately administering medications according to physician orders and established protocols.
Demonstrated proficiency with electronic health record systems for accurate inputting of patient information.
Managed complex medication regimens including IV therapy, injections, and oral medications for diverse patient populations.
Assisted in the development of streamlined medication administration procedures, resulting in increased accuracy and safety.
Collaborated with healthcare team members to ensure comprehensive, coordinated care for each patient.
Trained new Medication Technicians, ensuring adherence to best practices and quality standards.
Liaised effectively with pharmacists to clarify prescriptions, prevent potential drug interactions, or discuss alternative treatments as needed.
Participated actively in interdisciplinary team meetings, providing valuable insights on patients'' medication management and overall treatment plans.
Caregiver/ Personal Assistant
Wind Chime
08.2013 - 05.2014
Cleaned and organized living quarters, assisted residents with daily activities, and helped with personal care.
Assisted clients with activities of daily living, promoting independence and quality of life.
Cleaned house, ran errands, managed laundry, and completed weekly grocery shopping.
Assisted with dressing guidance, grooming, meal preparation, and medication reminders.
Performed light housekeeping duties to maintain cleanliness standards while respecting the patient''s personal space.
Assisted clients with daily living needs to maintain self-esteem and general wellness.
Built strong relationships with clients to deliver emotional support and companionship.
Engaged patients in meaningful conversation, socialization, and activity while providing personal care assistance.
Maintained a safe and clean environment for patients, reducing risks and ensuring optimal health outcomes.
Enhanced patient comfort by providing compassionate and attentive care, addressing individual needs and preferences.
Assisted with feeding and monitored intake to help patients achieve nutritional objectives.
Assisted patients with self-administered medications.
Maintained clean personal areas and prepared healthy meals to support client nutritional needs.
Provided emotional support to patients and their families during challenging times, fostering trust and strong relationships.
Administered medications as prescribed, ensuring accurate dosage and timely administration for maximum efficacy.
Provided safe mobility support to help patients move around personal and public spaces.
Contributed to a positive atmosphere for patients by using effective communication and active listening skills.
Coordinated closely with family members regarding updates on patient conditions or concerns that arose during the course of caregiving duties.
Prepared nutritious meals according to dietary restrictions, supporting clients'' overall health through balanced nutrition.
Supported clients with mental support and physical activities to accomplish quality of life and sustain needs.
Prioritized patient dignity, privacy, and autonomy during all aspects of care provision.
Recognized and reported abnormalities or changes in patients' health status to case manager.
Documented detailed daily reports on each client''s progress, informing adjustments in care plans when necessary.
Transported individuals to events and activities, medical appointments, and shopping trips.
Shift Lead/ Caregiver/Medication Tech
Courtyard at Little Chico Creek
12.2008 - 08.2013
Provided comfort and assistance to residents, managed medications, created schedules, and addressed resident and family concerns.
Completed store opening and closing procedures and balanced tills.
Trained new employees and delegated daily tasks and responsibilities.
Maintained a clean and organized work environment, ensuring safety standards were met consistently.
Oversaw cash handling procedures, ensuring accuracy and proper documentation at all times.
Trained and mentored new employees to maximize team performance.
Resolved customer complaints and issues and offered thoughtful solutions to maintain customer satisfaction.
Provided exceptional customer service by addressing inquiries, resolving issues, and maintaining a welcoming atmosphere for patrons.
Kept employees operating productively and working on task to meet business and customer needs.
Trained new employees on company policies, procedures, and best practices for optimal performance.
Helped store management meet standards of service and quality in daily operations.
Enhanced customer satisfaction through effective conflict resolution and prompt service.
Maintained clean and well-organized production areas to avoid violations or unnecessary work delays due to hazards or inefficient layouts.
Responded to and resolved customer questions and concerns.
Increased shift productivity by setting clear expectations and providing consistent guidance on job responsibilities.
Established positive rapport with customers and staff members alike through strong communication skills.
Enforced company policies and regulations with employees.
Supported upper management during critical decision-making processes by providing valuable insights based on firsthand experiences from shift operations.
Evaluated employee performance regularly, providing constructive feedback for growth opportunities within the team structure.
Mentored team members in professional development activities that ultimately led to promotions within the organization.
Education
High school -
Chico high
Chico, CA
Skills
Front Office (5 years)
Front Desk (10 years)
Scheduling (10 years)
Receptionist (5 years)
Cash Handling (3 years)
Billing (8 years)
Excel (5 years)
Outlook (10 years)
Management (5 years)
Microsoft Office (5 years)
Customer Service (10 years)
Microsoft Word (5 years)
HIPAA Compliance
Payment posting
Claim submission
Insurance Verification
Patient Billing
CPT Knowledge
Denial Management
ICD-10 Proficiency
Medicare and Medicaid process
Medical Coding Expertise
Bill payment
Accounts Payable
Collections Management
Disability claims process
Insurance Billing
Data Entry
Medical Billing
Medicaid and Medicare Knowledge
Keycompetence
Computer literate
Inventory & Record Management
Patient education & instruction
Supervising, training, & mentoring
Medical Biller
Timeline
Medical Billing Specialist
Retinal consultants medical group
03.2018 - 09.2024
Front office Supervisor
Center for Interventional Spine
12.2015 - 12.2017
Lead Medication Tech
Carlton Plaza
07.2014 - 01.2016
Caregiver/ Personal Assistant
Wind Chime
08.2013 - 05.2014
Shift Lead/ Caregiver/Medication Tech
Courtyard at Little Chico Creek
12.2008 - 08.2013
High school -
Chico high
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