Melanie Rene
East Freetown
Summary
Hardworking and passionate job seeker with strong organizational skills eager to secure an Accounts receivable position. Ready to help team achieve company goals. Enthusiastic and eager to contribute to team success through hard work, attention to detail and excellent organizational skills.
Overview
18
18
years of professional experience
Work History
Accounts Receivable/Medical Representative
South Coast Physicians Group
Fairhaven
08.2011 - Current
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Managed large volume of medical claims on daily basis.
- Paid or denied medical claims based upon established claims processing criteria.
- Responded to correspondence from insurance companies.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Reviewed provider coding information to report services and verify correctness.
- Carried out administrative tasks by communicating with clients, distributing mail and scanning documents.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Maintained confidentiality of patient finances, records and health statuses.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Medical Billing Specialist
MedPro Medical Management
Lakeville
06.2006 - 08.2011
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Posted and adjusted payments from insurance companies.
- Located errors and promptly refiled rejected claims.
- Precisely evaluated and verified benefits and eligibility.
- Identified and resolved patient billing and payment issues.
- Trained new employees on multiple medical billing programs and data entry software.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Prepared billing correspondence and maintained database to organize billing information.
- Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
- Collected payments and applied to patient accounts.
- Delivered timely and accurate charge submissions.
- Posted payments and collections on regular basis.
- Posted surgical charges for practice providers.
Education
High School Diploma -
New Bedford High School
New Bedford06.1995
Skills
- Flexible and Adaptable
- Self-Motivated
- Teambuilding
- Data Entry
- Multitasking Abilities
- Excellent Communication
- Teamwork and Collaboration
- Dependable and Responsible
- Attention to Detail
- Good Telephone Etiquette
Languages
Portuguese
Native or Bilingual
Timeline
Accounts Receivable/Medical Representative
South Coast Physicians Group
08.2011 - Current
Medical Billing Specialist
MedPro Medical Management
06.2006 - 08.2011
High School Diploma -
New Bedford High School
Similar Profiles
Angeles BlancoAngeles Blanco
Insurance Verification Specialist at Physicians Group Of South FloridaInsurance Verification Specialist at Physicians Group Of South Florida
Tianabelle RodriguezTianabelle Rodriguez
Referral Coordinator at Physicians Group Of South FloridaReferral Coordinator at Physicians Group Of South Florida
Dawn KnappDawn Knapp
Director of Recruiting at Providence Group Healthcare- South coast regionDirector of Recruiting at Providence Group Healthcare- South coast region
Rick HodgkinsRick Hodgkins
Marine Business Owner Operator at Rick's Outboard Marine IncMarine Business Owner Operator at Rick's Outboard Marine Inc
Alex J. ColumbusAlex J. Columbus
IT Specialist at Army National GuardIT Specialist at Army National Guard