Linda Brumley
Eastanollee,GA
Summary
Adept at enhancing revenue cycle efficiency and reducing billing errors, I leveraged my ICD-10 proficiency and exceptional customer service skills at Trubridge to significantly improve claim processing times. My expertise in medical coding guidelines and dedication to HIPAA compliance have been pivotal in fostering positive relationships with insurance carriers and optimizing billing procedures. Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment. Medical Billing and Coding Specialist with [Number] years providing administrative and patient support in hospital and medical office settings. Advanced knowledge of private insurance processes and codes. Disciplined individual skilled in collecting and verifying patient demographic and insurance information and preparing and maintaining medical records. Proficient in using medical terminology and classifying diagnostic procedures, treatments and medications. Dedicated to providing highest quality care to patients. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
26
26
years of professional experience
Work History
Medical Coding and Billing Specialist
Trubridge
08.2016 - Current
- Developed a comprehensive understanding of ICD-10-CM, CPT, and HCPCS codes to ensure proper use in medical coding assignments.
- Reduced errors in medical billings, effectively addressing discrepancies and rectifying issues promptly.
- Optimized revenue generation through diligent monitoring of denied claims, resubmitting corrected information when needed.
- Established positive relationships with insurance companies, facilitating open communication lines for efficient claim processing.
- Contributed to team success by actively participating in staff meetings, offering insights into improving workflows within the department.
- Maximized productivity through effective time management, prioritizing tasks based on urgency and importance.
- Achieved timely reimbursements from payers by submitting clean claims that adhere to payer-specific guidelines.
- Streamlined billing processes for faster reimbursement, utilizing advanced software solutions.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Followed up with medical staff regarding missing information in patient records.
- Input data into computer programs and filing systems.
- Scanned and uploaded medical records into electronic medical records system.
- Maintained accuracy, completeness, and security for medical records and health information.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Followed exact procedures for handling transfers and other releases of medical records.
- Billing and Collection procedures expert
- HCPCS Coding Guidlines
- Familiar with Commercial and Medicare Insurance Carriers
Billing Specialist
Habersham Medical Center
04.2004 - 05.2015
- Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
- Researched and resolved billing discrepancies to enable accurate billing.
- Provided excellent customer service, developing and maintaining client relationships.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Worked with multiple departments to check proper billing information.
- Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Developed and maintained billing procedures to make timely payments.
- Maintained detailed records of each account''s payment history, providing easy access to information for audit and analysis purposes.
- Processed and verified invoices to secure accuracy of billing information.
- Optimized workflow processes for increased productivity within the Billing Department, enabling staff members to focus on more strategic tasks.
- Maximized revenue potential by identifying and resolving under-billed accounts.
- Ensured compliance with industry regulations by staying up-to-date on changes in billing rules and guidelines.
- Responded to customer concerns and questions on daily basis.
- Used data entry skills to accurately document and input statements.
- Audited and corrected billing and posting documents for accuracy.
Medical Representative
WellStar
04.1998 - 05.2004
- Established strong relationships with healthcare professionals, resulting in increased trust and credibility for the organization.
- Maintained accurate records by updating patient demographics, insurance, and financial information.
- Supported hospital compliance efforts by adhering to HIPAA guidelines and maintaining the confidentiality of patient information.
- Improved overall work environment through active participation in department meetings, sharing ideas for enhancements, and supporting team-building initiatives.
- Implemented time-saving strategies for quicker completion of registration tasks without compromising accuracy or quality of service.
- Provided thorough information about admissions policies, financial requirements, and check-in procedures.
- Managed high-stress situations calmly while assisting patients experiencing medical emergencies or other urgent matters.
- Collected demographic and insurance information from patients.
- Verified insurance benefits, processed payments, and issued receipts.
- Determined appropriate appointment type and scheduled each in system.
- Reduced errors in data entry through thorough review of inputted information and timely corrections when necessary.
- Streamlined the admissions process for improved patient satisfaction and reduced wait times.
- Enhanced patient registration experience by efficiently gathering and verifying required information.
- Organized, checked and submitted all related paperwork.
- Completed registration paperwork, verifying accurate patient information.
- Answered patient questions and inquiries regarding registration process and documentation.
- Coordinated scheduling for patient follow-up appointments in accordance with physician requests.
- Confirmed patient demographics and updated practice management software for accuracy.
- Assisted other clerks with front desk duties, answering questions and accurately using reservation system.
- Assisted in processing patient payments via cash, checks and credit cards.
- Welcomed as many as [Number] patients daily, directing to appropriate departments within facility and coordinating assistance with transportation.
- Verified insurance benefits and obtained pre-authorizations before any medical procedures were performed.
- Entered patient information into payment system accurately for billing purposes.
- Scheduled patient appointments, collected copays and verified insurance coverage to complete check-ins.
- Reviewed, processed, and issued application requests for [Type] registration.
- Updated patient contact information to support accurate electronic medical records.
- Operated standard office software applications to compile data and prepare information and correspondence.
- Safeguarded patient privacy with strict adherence to data security protocols related to electronic health records.
- Retrieved medical data for physicians and patients.
- Upheld HIPAA regulations and standards for protecting patient information.
- Performed regular quality and validation assessments on patient data to verify accuracy.
Education
No Degree - Medical Coding Certification
Penn Foster
Online05.2016
No Degree - Medical Coding
North Georgia Technical College
Clarkesville, GA05.2013
High School Diploma -
Clay County High School
Manchester, KY05.1982
Skills
- CPT coding knowledge
- ICD-10 Proficiency
- Medical record review
- HIPAA Compliance
- Medical terminology expertise
- Insurance coding (ICD-9 and CPT)
- Medical Coding Guidelines
- Medical Abbreviations
- Claims Processing
- Revenue Cycle Management
- Medical Coding Certification
- Payment posting
- Patient confidentiality
- Healthcare Reimbursement
- Denial Management
- Insurance Verification
- Data Entry
- Medical Terminology
- Medical Billing
- Workflow Management
- Clinical Documentation
- Insurance claims analysis
- Proficiency in [Software]
- Medical record security
- Regulatory guidelines
- Data Verification
- Knowledgeable in [Software]
- Medical claims coding
- Training and mentoring
- Performance Improvement
- ICD-10 Coding
- Protected Health Information
- Insurance Billing
- Patient Information Verification
- Medical Billing Processing
- Medical Release of Information ROI processes
- Insurance and Coding Specialist
- Paperwork Processing
- Heartsaver First Aid CPR AED (First Aid CPR AED)
- Customer Service
- Electronic Filing System Organization
- Billing Procedures
- Medical billing code accuracy
- Patient Rights
- Appointment Scheduling
- ICD-9 Coding
- DRGs Patient Assignments
- Patient Health Information Access
- Workers' Compensation Forms
- Patient Admission
- Information Classification
Timeline
Medical Coding and Billing Specialist
Trubridge
08.2016 - Current
Billing Specialist
Habersham Medical Center
04.2004 - 05.2015
Medical Representative
WellStar
04.1998 - 05.2004
No Degree - Medical Coding Certification
Penn Foster
No Degree - Medical Coding
North Georgia Technical College
High School Diploma -
Clay County High School