Mary Guyton
Fort Worth, TX,TX
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Precise and engaging Billing Specialist executes flawless invoicing for products and services. Consistent high-achiever leverages computerized invoicing tools to streamline processes. Dedicated to employing innovative and traditional practices to collect past-due receivables.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Billing & Coding Specialist
Women’s Care - Florida
Tampa, FL
07.2017 - 07.2023
- Reviewed patient records to verify accuracy of billing information and coding.
- Prepared accurate claims for submission to insurance companies, including Medicare and Medicaid.
- Processed payments from insurance companies, patients, and other third-party payers in a timely manner.
- Performed data entry tasks such as entering charges into the system and updating patient accounts.
- Resolved discrepancies between billed amounts and payment received from insurance companies or patients.
- Verified medical codes with physicians and other healthcare providers to ensure accuracy of billing information.
- Assisted with research on denied claims, identifying corrective action needed for resubmission.
- Provided customer service support to patients regarding billing inquiries or issues.
- Maintained current knowledge of applicable rules, regulations, laws, standards, and guidelines related to healthcare billing and coding procedures.
- Participated in training sessions related to updates in coding requirements or changes in reimbursement policies.
- Created reports summarizing financial activity for management review purposes.
- Analyzed trends in denials and reimbursement patterns across different insurers.
- Collaborated with internal departments such as finance and accounting when resolving complex billing issues.
- Identified areas of improvement within the existing processes used for collecting payments from patients or insurers.
- Monitored accounts receivable aging reports on a regular basis to identify any outstanding balances owed by payers.
- Generated monthly invoices for services rendered according to contractual agreements with clients.
- Managed follow-up activities associated with unpaid or partially paid claims until resolution is achieved.
- Investigated and resolved issues to maintain billing accuracy.
- Answered customer invoice questions and resolved issues discovered during invoicing and collection process.
- Worked with team members and leadership to identify and develop process improvements.
Charge Entry Specialist
Women’s Care - Florida
Tampa, FL
07.2002 - 06.2017
- Reviewed patient records to ensure accuracy of charge entry information.
- Verified insurance eligibility and benefits for services rendered.
- Processed corrections and adjustments to existing claims as necessary.
- Maintained daily logs of charges entered into the system.
- Entered data regarding patient demographics, diagnoses, treatments, procedures, and charges accurately into billing systems.
- Answered questions from internal staff members regarding charge entry policies and procedures.
- Performed quality assurance checks on all charge entries before submission to payers.
- Assisted with researching denied claims and preparing appeals when necessary.
- Submitted clean claims electronically via various clearinghouses or direct-to-payer connections.
- Processed credit balance refunds according to established guidelines.
- Responded promptly to inquiries from patients, payers, or other external parties concerning billing issues.
Education
Insurance Coding Specialist - Vocational-Technical Education
Concorde Career College
Tampa, FL06-2002
High School Diploma -
Wayne County High School
Jesup, GA06-1990
Skills
- Problem-solving capabilities
- Revenue Cycle Management
- HIPAA Compliance
- Insurance Verification
- Payment posting
- Data Entry Speed
- Patient Account Resolution
- Continuous learning mindset
- Third-Party Payer Guidelines
- Clinical Documentation Review
- Medical Coding Expertise
- HCPCS Level II Familiarity
- ICD-10 Proficiency
- CPT coding knowledge
- Medical Terminology Mastery
- Denial Management
- Charge Entry Accuracy
- Claims Processing
- Accounts receivable expertise
- Medical billing and collections
- Coding proficiency
- Customer Service
Certification
- Professional Association of Healthcare Coding Specialist Certification
References
References available upon request.
Timeline
Billing & Coding Specialist
Women’s Care - Florida
07.2017 - 07.2023
Charge Entry Specialist
Women’s Care - Florida
07.2002 - 06.2017
Insurance Coding Specialist - Vocational-Technical Education
Concorde Career College
High School Diploma -
Wayne County High School
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