Kerrian Miller
Jacksonville,US
Summary
Precise, efficient medical billing professional with over 6 years of experience in inpatient, outpatient, and physician medical billing. Specialize in filing accurate claims, adjusting rejected claims, and understanding insurance contracts, appeals, and EOBs. Gained expertise in all aspects of medical revenue cycle management including filing claims, refund requests, re-filing rejected claims, completing appeals, and adjusting underpayments, and posting payments. Committed to staying up to date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service, and managed care plans. Knowledge of HMOs, Medicare, Government payors, and Medicaid.
Overview
17
17
years of professional experience
Work History
Insurance Follow-Up Specialist, Authorization Specialist
Shands Jacksonville Medical Center
09.2019 - Current
- Follow up on outstanding insurance claims, including denials or underpayments
- Verify insurance coverage and eligibility for patients
- Identify and report any potential issues or trends affecting claim reimbursement
- Investigate and resolve claim rejections or discrepancies by gathering necessary documentation and communicating with insurance carriers
- Document and update patient accounts with accurate and detailed information related to insurance claims and payments
- Collaborate with healthcare providers to obtain additional information or documentation required for claim processing
- Provide excellent customer service to patients, insurance companies, and healthcare providers regarding insurance-related inquiries
- Prioritize incoming authorization requests according to urgency
- Review chart documentation to ensure patient meets medical policy guidelines
- Obtain authorization via payer website or by phone and follow up regularly on pending cases
- Initiate appeals for denied authorizations
- Confirm accuracy of CPT and ICD-10 diagnoses in procedure order.
Medical Billing Specialist
Xpress Technologies
04.2018 - 05.2019
- Prepare, review, and submit medical claims to insurance companies, ensuring all necessary documentation and coding are accurate and complete
- Analyze and reconcile insurance payments with billed amounts, identifying and resolving any discrepancies or errors
- Generate and send invoices to patients for services rendered, including any copayments, deductibles, or outstanding balances
- Record and post payments received from insurance companies and patients, reconciling balances and updating patient accounts accordingly
- Review medical records and assign appropriate diagnosis and procedure codes based on established coding guidelines (e.g., CPT, ICD-10, HCPCS) to ensure accurate claim submission.
Payment Posting Specialist
Complete Practice Management
03.2017 - 03.2018
- Accurately record and post payments received from patients and insurance companies to the appropriate patient accounts in the billing system
- Reconcile payments against billed amounts, identifying and resolving any discrepancies or errors
- Process refunds to patients or insurance companies for overpayments, duplicate payments, or erroneous payments
- Apply adjustments or write-offs to patient accounts as necessary, based on insurance contracts, contractual allowances, or other approved guidelines
- Analyze Explanation of Benefits (EOB) statements received from insurance companies to ensure accurate payment posting and identify any issues or discrepancies.
Insurance Follow-Up Specialist
North Florida OB/GYN
02.2014 - 04.2016
- Follow up on outstanding insurance claims, including denials or underpayments
- Investigate and resolve claim rejections or discrepancies by gathering necessary documentation and communicating with insurance carriers
- Maintain up-to-date knowledge of insurance regulations, policies, and coding guidelines.
Support Specialist
JCPenny
07.2012 - 09.2013
- Process merchandise to transport to sales floor
- Engage with customers and recommend products based on needs and requests.
Warehouse Order Selector
D And H Distributing
05.2007 - 07.2011
- Prepare orders by processing requests, pulling materials from warehouse, packing boxes, and preparing shipments
- Inspect incoming and outgoing shipments to verify accuracy and prevent errors.
Education
Associate of Science - Healthcare Management
Ultimate Medical Academy
Clearwater, FLSkills
- Problem-solving and analytical
- Time management and organizational
- Attention to detail
- Knowledge of medical billing and coding
- Insurance claim processing
- Epic healthcare software
- Strong communication
- Customer Service
- Medical terminology knowledge
- Technical
- Multitasking
Timeline
Insurance Follow-Up Specialist, Authorization Specialist
Shands Jacksonville Medical Center
09.2019 - Current
Medical Billing Specialist
Xpress Technologies
04.2018 - 05.2019
Payment Posting Specialist
Complete Practice Management
03.2017 - 03.2018
Insurance Follow-Up Specialist
North Florida OB/GYN
02.2014 - 04.2016
Support Specialist
JCPenny
07.2012 - 09.2013
Warehouse Order Selector
D And H Distributing
05.2007 - 07.2011
Associate of Science - Healthcare Management
Ultimate Medical Academy
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