Skilled medical billing professional with knowledge and some experience in coding, charge entry, billing and claims processing. Detail-oriented with a strong track record in resolving billing discrepancies and addressing claim denials.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Government Claims Admin 2
Baptist Health Hospital
06.2022 - Current
Ensured compliance with HIPAA regulations while managing sensitive patient information.
Reviewed and verified accuracy of patient information, including insurance eligibility.
Researched and corrected claim denials to facilitate smooth processing.
Contacted insurance companies for assistance in resolving complex issues.
Increased revenue by accurately reviewing and submitting medical claims for reimbursement.
Medical Billing and Collections Specialist
Help At Home
04.2019 - 05.2022
Maintained comprehensive billing records in accordance with company policies.
Processed claims by correcting and completing required payer codes.
Submitted claims to Medicare, Medicaid, and commercial insurance for reimbursement approval.
Identified discrepancies and resolved carrier issues related to billing and reimbursements.
Monitored overdue accounts while pursuing collections on outstanding invoices.
Forwarded processed claims to various insurance providers for timely processing.
Charge Entry Specialist
Northside Hospital
12.2017 - 03.2019
Processed and transmitted clean orthopedic claims for all commercial and government payers daily.
Verified patient insurance coverage to ensure billing accuracy.
Included appropriate modifiers, ICD-10, and CPT codes in claims submissions.
Resolved claim rejections and errors promptly to maintain workflow efficiency.
Conducted follow-ups on unpaid claims within established billing cycles.
Researched services and diagnoses to guarantee accurate billing practices.
Managed CMS-1500 claims processing to uphold compliance standards.
Payment Posting Specialist
Emory Healthcare
07.2011 - 04.2017
Managed patient account payments, ensuring accurate posting and tracking of transactions.
Assisted with month-end and year-end closing processes for financial accuracy.
Balanced daily cash postings with deposits to verify information accuracy in the system.
Trained new team members on procedures for posting payments and reconciling accounts receivable.
Displayed adaptability by staying current with industry regulations and payer-specific policies, ensuring compliance in all payment posting activities.
Optimized payment posting processes for faster reimbursement, tracking payments from various sources including insurance companies, Medicare, Medicaid, and private payers.
Education
Associate of Science - Health Information Technology
DeVry University
Decatur, GA
10.2008
High School Diploma -
Cedar Grove High School
Ellenwood, GA
Skills
Certified professional coder
Insurance verification
ICD-10 and CPT coding
Client service excellence
Attention to detail
Time management
Billing and coding specialist
Medicare and Medicaid expertise
Claims processing
Certification
AAPC, Certified Professional Coder
Timeline
Government Claims Admin 2
Baptist Health Hospital
06.2022 - Current
Medical Billing and Collections Specialist
Help At Home
04.2019 - 05.2022
Charge Entry Specialist
Northside Hospital
12.2017 - 03.2019
Payment Posting Specialist
Emory Healthcare
07.2011 - 04.2017
Associate of Science - Health Information Technology