Jeannine Tanner
Yulee,FL
Summary
Efficient medical biller with 3 years of experience.
I excel in customer service, effectively collaborate with internal and external clients, and possess strong problem solving skills. Willingness to take on added responsibilities to meet team goals while maintaining attention to detail and accurateness.
Overview
1
1
year of professional experience
Work History
Account Solutions Complex Medical Billing
CVS Specialty Pharmacy
05.2023 - Current
- Managed a diverse caseload of complex medical billing issues, ensuring timely resolution to maintain positive relationships with patients and providers alike.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
- Reviewed claims that were denied for accuracy and followed up with outbound calls or electronic communication to verify benefits and resubmit claim for payments.
- Work daily with payor portals and maintain working knowledge of HMO's, Medicare, Medicaid, PPOs, EPOs and third party payors.
- Enhanced revenue by efficiently processing medical billing claims and an understanding of the revenue cycle and forms needed to successfully resolve unpaid claims.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Reduced claim denials by diligently following up with insurance companies and promptly addressing any discrepancies.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Collected payments and applied to patient accounts.
- Posted payments and collections on regular basis.
Pharmacy Services Specialist
CVS Specialty Pharmacy
01.2023 - 05.2023
- Confidently protects patients rights by always maintaining compliance with HIPAA standards and regulations.
- Reduced medication errors by understanding procedure and diagnosis relationships and knowledge of medical terminologies ensuring correct coding for accurate claim submission for payment of specialty medications.
- Answered incoming phone calls and addressed questions from patients, PSRs, pharmacists, providers, payors and benefit verification representatives.
- Set up and modified patient profiles to include current medications and insurance details.
- Efficiently updated primary and secondary insurance policies and checked claims for accuracy to ensure payment.
- Reviewed denied claims and worked to verify patients benefits including PA verifications, ICD-10 code accuracy, deductible and OOP coverage and accumulator reviews.
Education
Associate of Science - Medical Billing
Ultimate Medical Academy
Clearwater, FL05.2023
Skills
- ICD-10 Knowledge
- Claims Processing Proficiency
- Organizational abilities
- Data Entry Efficiency
- Medical Billing
- Billing and Collection Procedures
- Insurance claims processing
- Critical Thinking
- Insurance Verification
- Medical Terminology
- CPT Coding Familiarity
- Continuous Learning Attitude
- Payment Posting Abilities
- Medical Terminology Mastery
- HIPAA Compliance
Timeline
Account Solutions Complex Medical Billing
CVS Specialty Pharmacy
05.2023 - Current
Pharmacy Services Specialist
CVS Specialty Pharmacy
01.2023 - 05.2023
Associate of Science - Medical Billing
Ultimate Medical Academy