Marica Taylor
Martinsburg,WV
Summary
Detail-oriented Administrative Professional experienced in Medical Billing and Coding. Delivered effective solutions through strong problem-solving skills and proactive approach to challenges. Committed to advancing organizational goals and contributing to overall business success.
Overview
1
1
Certification
17
17
years of professional experience
Work History
Authorization Specialist
MEDBRIDGE GROUP
Baltimore, MD
01.2024 - Current
- Verifying insurance benefits, calling patients, scheduling appointments, scanning, faxing, sending/checking emails, obtaining prior authorizations
- Obtained referrals for uninsured patients to ensure access to necessary care
- Obtaining referrals for patients when they are not covered
- Updating patient information/keeping records
- Applied strong computer skills to streamline daily operations, ability to multi-task and work as part of team in fast paced office environment
- Verified insurance benefits and coordinated patient communications, appointments, and prior authorizations
Medical Biller
Fort Health Medical Group of NJ
Jersey City, NJ
03.2025 - 10.2026
- Reviewed insurance eligibility, benefits, and prior authorizations to support clean claim submission.
- Processed medical claims using CPT, ICD-10, and HCPCS coding guidelines for accurate reimbursement.
- Followed up on denied claims and unpaid accounts to resolve billing discrepancies and reduce delays.
- Posted payments, adjustments, and write-offs in practice management systems with careful accuracy.
- Maintained compliance with HIPAA, payer policies, and internal revenue cycle procedures.
- Investigated claim edits and documentation gaps to improve billing accuracy and collection outcomes.
- Supported front-office and clinical teams with billing questions, coding updates, and account research.
- Verified insurance of patients to determine eligibility.
- Filed and updated patient information and medical records.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Liaised between patients, insurance companies, and billing office.
Revenue Recovery Specialist
Knowtion Health
Boca Raton, FL
10.2023 - 04.2024
- This Specialist communicated professionally with payers and patients daily while managing multiple tasks and priorities.
- Pursue & obtain information needed to overturn claim denials, including patient & responsible party information, medical necessity, employer information, accident information
- Ensure appropriate timely filing guidelines are met for maximum reimbursement
- Pursued and obtained critical information to overturn claim denials, including patient, responsible party, medical necessity, employer, and accident details
- Ensured compliance with timely filing guidelines to maximize reimbursement opportunities
- Identify and discuss root cause issues with management
- Identified and discussed root cause issues with management to enhance resolution strategies
- Consequences to errors in judgment are critical (HIPAA violation penalties, lost revenue for hospital client, other penalties, or fines)
Charge Poster/ Medical Biller
JD Matthews & Associates, LLC
Winchester, VA
10.2020 - 09.2023
- Enter charges/payments/adjustments into the billing software accurately and in a timely manner to decrease the timeframe from date of service to reimbursement for procedures.
- Identified and reported trends in payer processing errors and improper claim retractions to enhance claim accuracy.
- Balance surgical and clinical procedures on a daily, and monthly basis to ensure all services are accounted for and billed.
- Balanced payments processed through billing department, ensuring accurate financial tracking from front office to back office.
- Identify and report trends in regards to payer processing errors and improper claim retractions.
- Corrected claims and reprocessed them for approval.
- Distributed payments across accounts to ensure accurate financial records. throughout account inquiry from general accounts to collections.
Registration Specialist- PER DIEM
Valley Health Urgent Care
Ranson, WV
05.2019 - 10.2020
- Registration and discharge: Process patient registration and discharge, and follow up on no-show patients
- Insurance: Verify insurance benefits and eligibility, and identify services that require authorization
- Verified insurance benefits and eligibility, identified services requiring authorization to ensure patient coverage
- Collected co-pays and deductibles, coordinated financial arrangements to facilitate patient access to care
- Entered patient information into database, organized records to enhance efficiency of hospital information system
- Performed additional duties to ensure smooth patient flow and compliance with hospital protocols.: Assign beds, adhere to hospital rules, and ask patients to sign forms
Registration Specialist- FULLTIME
Berkeley Medical Center
Martinsburg, WV
07.2017 - 10.2020
- Registration and discharge: Process patient registration and discharge, and follow up on no-show patients
- Processed patient registration and discharge, ensuring accurate patient flow and effective follow-up on no-show patients
- Verified insurance benefits and eligibility, identifying required authorizations to facilitate patient access to necessary services
- Collected co-pays and deductibles, coordinating financial arrangements to streamline payment processes
- Initial interviews: Gather demographic and financial information from patients
- Assisted with various administrative tasks to support hospital operations.: Assign beds, adhere to hospital rules, and ask patients to sign forms
Client Service Representative I- FULLTIME
Ciox Health
Hagerstown, MD
10.2016 - 06.2017
- Dedicated 40 hours each week to support team goals.
- Managed release-of-information requests, ensuring accurate medical record disclosure and HIPAA compliance.
- Coordinated patient, provider, and attorney inquiries through phone, email, and fax communications.
- Verified request documentation, authorization validity, and patient identity before processing sensitive health information.
Financial Intake Coordinator- FULLTIME
LHC Group
Frederick, MD
06.2016 - 10.2016
- Committed 40 hours weekly to maintain job responsibilities
- Coordinated referral intake, ensuring timely processing of patient information and eligibility documentation.
- Verified insurance coverage and authorization requirements for incoming home health referrals.
- Collaborated with referral sources, clinicians, and branch staff to support seamless patient admissions.
Receptionist- FULLTIME
Gastroenterology Associates
Hagerstown, MD
06.2014 - 05.2016
- Dedicated 40 hours each week to support team operations
- Managed patient check-in, demographic updates, and insurance verification for gastroenterology appointments.
- Scheduled consultations, procedures, and follow-up visits using electronic medical record systems.
- Coordinated referrals, authorizations, and documentation to support timely patient care.
Patient Access Specialist- FULLTIME
Valley Health
Winchester, VA
08.2012 - 05.2014
- Committed to a consistent workweek of 40 hours
- Verified patient demographics and insurance eligibility to support accurate registration workflows.
- Scheduled appointments while coordinating referrals, authorizations, and provider availability.
- Collected copayments and explained financial responsibilities using clear, patient-focused communication.
Receptionist- FULLTIME
Dr. L. J. DelGiorno
Martinsburg, WV
01.2011 - 08.2012
- Dedicated 40 hours each week to ensure consistent workflow.
- Managed patient check-in, demographic updates, and appointment scheduling for high-volume gastroenterology visits.
- Verified insurance eligibility, referrals, and authorizations before patient appointments.
- Coordinated incoming calls, routed clinical questions, and escalated urgent concerns to medical staff.
Outbound Department- FULLTIME
Home Depot
Winchester, VA
01.2010 - 08.2012
- Committed to 40-hour work weeks
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
Education
Health Info Management
University of Phoenix
Phoenix, AZCERTIFICATE - MEDICAL BILLING AND CODING
Blue Ridge Community and Technical College
Martinsburg, WV08-2018
Ancillary and Clinical User
Precyse University
Front Royal, VA12-2013
Diploma - undefined
Martinsburg High School
Martinsburg, WV05-1999
Nursing/ Medical Assisting
Martinsburg, WV08-2013
Skills
- ICD-10
- ICD Coding
- CPT Coding
- Quality control
- Medical Billing
- Administrative Support
- Authorization processing
- Proofreading
- Data Entry
- Claims Documentation
- Microsoft Excel
- Client support
- Microsoft Outlook
- Healthcare Documentation
- Medical Terminology
- Medical records
- Documentation management
- Quality Assurance
- ICD classification
- Medical imaging
- Medical Billing
- Triage
- Office management
- Physiology
- Billing Software
- Anatomy
- Telephone etiquette
- Front desk
- Administering injections
- Telephone etiquette
- Great telephone etiquette
- Patient records
- Communication skills
- Attention to detail
- Time management
- CPT classification
- Problem-solving
- Billing procedures
- Physiology Knowledge
- Anatomy Knowledge
- Hospital work
- Medical Imaging
- Medical vocab
- Computer Operation
- Coverage verification
- Injection administration
- Reporting documentation
- Healthcare Environment
- Issue Resolution
- Microsoft Office
- Positive Attitude
- Patient Advocacy
- Hospital Experience
- Terminology expertise
- Medical Mastermind
- GMed
- Medstar
- Allscripts
- Claim Review
- Centricity
- Claims processing
- Documentation gaps
- Data entry
- Filling out documentation required for billing
- Organizing patient records
- Patient registration
- Documentation
- Confidentiality
- Reporting
- Effective communication
- Proofreading
- Eligibility checks
- Data Protection
- Attention to detail
- Time management
- Problem-solving
- Team collaboration
- Problem-solving
- Multitasking
- Critical thinking
Accomplishments
- Completed Medical billing and coding program at Blue Ridge CTC.
- Completed epic superuser program through Valley health
Certification
- Medical Billing & Coding
- December 2017 to Present
- Medical Billing Certification
- Certified Professional Coder
- Certified Coding Specialist
- Medical Coding Certification
Timeline
Medical Biller
Fort Health Medical Group of NJ
03.2025 - 10.2026
Authorization Specialist
MEDBRIDGE GROUP
01.2024 - Current
Revenue Recovery Specialist
Knowtion Health
10.2023 - 04.2024
Charge Poster/ Medical Biller
JD Matthews & Associates, LLC
10.2020 - 09.2023
Registration Specialist- PER DIEM
Valley Health Urgent Care
05.2019 - 10.2020
Registration Specialist- FULLTIME
Berkeley Medical Center
07.2017 - 10.2020
Client Service Representative I- FULLTIME
Ciox Health
10.2016 - 06.2017
Financial Intake Coordinator- FULLTIME
LHC Group
06.2016 - 10.2016
Receptionist- FULLTIME
Gastroenterology Associates
06.2014 - 05.2016
Patient Access Specialist- FULLTIME
Valley Health
08.2012 - 05.2014
Receptionist- FULLTIME
Dr. L. J. DelGiorno
01.2011 - 08.2012
Outbound Department- FULLTIME
Home Depot
01.2010 - 08.2012
Nursing/ Medical Assisting
Diploma - undefined
Martinsburg High School
Ancillary and Clinical User
Precyse University
Health Info Management
University of Phoenix
CERTIFICATE - MEDICAL BILLING AND CODING
Blue Ridge Community and Technical College
RELATED COURSEWORK
- Medical Terminology
- Keyboarding
- Human Body
- Human Growth and Development
- Intro to Medical Assisting
- Intro to Health Care
- Medical Office Management
- Information Literacy
- Fundamentals of Information Systems for Healthcare
- HIPPA Security Basics for the Healthcare Workforce
- The Privacy Rule and Healthcare Practice
- ICD 9
- ICD10
- Insurance Billing
- Manual claim filing
- Use of coding manuals CPT, GEMS mapping and HCPCS
- Completion of Insurance forms
- Tracing of delinquent claims
- Appeal of denied claims
- Basic claims processing for medical insurance and third-party reimbursement
- MEDICAL OFFICE EXPERIENCE
- Facilitate/process secure messaging with the patient and team.
- Notify patients of normal lab results.
- Develop and manage a tracking system for follow up care such as consults, tests, etc.
- Monitoring pre-appointment requirements to assure readiness for patient visit/procedure (e.g., X-ray, lab work).
- Participate in team huddles and team meetings to manage and plan patient care.
- Setting priorities and deadlines, adjusting the flow and sequencing of the work to meet team and patient needs.
- Work with the team to reinforce the plan of care and self-help solutions and entering appropriate information into the electronic record.
- Work collaboratively in an interdisciplinary coordinated care delivery model (i.e.,patient aligned care team, or other specialty care setting where the patient aligned care team model is used such as oncology, HIV, SCI, Military Sexual Trauma, etc.).
- Coordinate with the patient care team to review the clinic utilization by using various reports (e.g., Clinic Utilization Statistical Summary).
- Ensure that the clinic setup is closely monitored to effectively support the needs of the clinic, and make any necessary adjustments and etc..
- Coordinate with their PACT during scrub activities, arranging clinic cancelation, blocking and rescheduling.
- Review open encounters daily and coordinate with PACT to ensure timely closure.
- Perform basic eligibility requirements as noted in the VA policy.
- Provide input to problem solving on PACT and provides follow-up actions, sharing information and collaboration with PACT and Medical center staff; order administrative supplies.
- Other duties as assigned.
- EXPERIENCE
- I have extensive experience servicing customers and providing customer support for an organization/business
- Proper telephone etiquette to provide excellent customer service for an organization/business
Personal Information
Title: EXPERIENCED MEDICAL BILLER AND AUTHORIZATION SPECIALIST