Experienced Billing/AR Specialist and medical professional skilled in various medical capacities and specialties including Mental health, primary care, pediatrics and cardiology. Committed to providing exceptional medical billing and accounts receivable services to practices as well as patients while following HIPAA regulations and policies. Dedicated to work collaboratively as an effective team member and accomplish individual responsibilities.
Overview
8
8
years of professional experience
Work History
Medical Billing AIR Specialist
Cardiovascular Institute of Central Florida
Ocala
05.2021 - Current
Submit timely and accurate claims (UB-04/CMS-1500) to payers, ensuring compliance with regulatory and payer-specific requirements
Work claim edits and correct errors in demographic, insurance, and charge data to ensure clean claim submission
Executed prompt follow-up on outstanding receivables, addressing appeals and disputes for denials and underpayments to enhance cash flow.
Managed appeals, reconsiderations, and recoupments to address payer disputes effectively.
Resolved payer overpayments promptly, ensuring regulatory compliance and mitigating risk of future recoupments.
Analyzed denial reasons and payment variances to pinpoint root causes, recommending targeted process improvements.
Conducted thorough verification of patient eligibility and demographics to maintain data integrity.
Billing AIR Specialist 3
Meridian Behavioral Healthcare
Gainesville
05.2019 - 05.2021
Submit timely and accurate claims (UB-04/CMS-1500) to payers, ensuring compliance with regulatory and payer-specific requirements.
Collaborated with payers and internal departments to resolve issues, ensuring timely account resolution.
Review patient accounts for accuracy in demographics, insurance coverage, and billing details.
Work claim edits and correct errors in demographic, insurance, and charge data to ensure clean claim submission.
Conducted thorough follow-up on outstanding receivables, addressing appeals and disputes for denials and underpayments.
Identified patterns in denials and reimbursement discrepancies to inform corrective actions.
Appeals/reconsiderations/disputes/overpayments
Processed all third-party accounts receivable, tracking progress and ensuring follow-up.
Executed payment postings and deposit verifications to maintain financial integrity.
Authorizations with Va Community Care
Health Support Specialist
Department of Health Marion County
Ocala
10.2017 - 05.2019
Checked in clients and documented charts for service eligibility.
Interviewed clients to assess eligibility for assistance.
Verify insurance, checking Florida Medicaid System
Reviewed paperwork for accuracy and documentation
Recorded DX and CPT codes after verifying and submitting claims.
Once approved for assistance, issue benefits to clients
Check HGB and anthropometrics of women, Infants, and children
Retrieve payments for services if no MCD
Education
Billing and Coding Certification -
Penn Foster College
05-2026
Certificate of Completion of Florida Nutrition Guide for Basic, Prenatal, Infant, Preschool, and Breastfeeding -
Florida Department of Health Marion County
03-2018
Skills
Medical coding
Insurance verification
Claims processing
Aging reports/accounts receivable
ICD-9
ICD-10
CPT codes
Electronic Medical Records
HIPAA Confidentiality
Knowledge of CMS Guidelines
Medicare/Medicaid/All Commercial
VA/WC/Contracts
Centricity system
Athena Health system
PLEXIS System
Microsoft office
Excel
Adobe
Complex Problem Solving
Employee relations
Core Strengths & Highlights
Timeline
Medical Billing AIR Specialist
Cardiovascular Institute of Central Florida
05.2021 - Current
Billing AIR Specialist 3
Meridian Behavioral Healthcare
05.2019 - 05.2021
Health Support Specialist
Department of Health Marion County
10.2017 - 05.2019
Billing and Coding Certification -
Penn Foster College
Certificate of Completion of Florida Nutrition Guide for Basic, Prenatal, Infant, Preschool, and Breastfeeding -
Insurance and Billing Medical Coding Specialist at Peachtree Cardio Vascular and PodiatryInsurance and Billing Medical Coding Specialist at Peachtree Cardio Vascular and Podiatry