Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Timeline
Generic

Misty Spoores

Medical Biller Specialist
San Antonio,TX

Summary

Reliable Medical Biller Specialist with coding and medical terminology knowledge. Polished and hardworking performer with background overseeing accounts and handling records management tasks. Team-oriented person with great decision-making skills. Driven Medical Biller motivated to perform beyond expectations. Outgoing and organized, with solid foundation in medical terminology and patient care standards. Knowledge of healthcare billing procedures and proficient in coding and insurance claim processing. Dedicated to improving billing accuracy and efficiency to support healthcare providers. Experienced with medical billing processes, including claim submission and follow-up. Utilizes knowledge of insurance guidelines to ensure accurate and timely billing. Track record of effective communication and problem-solving, consistently supporting healthcare providers' financial goals.

Overview

16
16
years of professional experience
2
2
Certification

Work History

Medical Biller Specialist

VRA, PC( Remote)
05.2019 - 02.2025
  • Verified insurance, billing and coding, updated patient data, entered charge information into the EHR.
  • Processed medical claims and invoices for physicians and ambulatory hospital, coded claims and submitted to insurance companies, verified and audited chart and coding.
  • Reviewed and resolved denied claims for either CMS-1500 and/or UB-04.
  • Developed payment plans.
  • Prepared invoices collected payments.
  • Followed up with insurance companies on unpaid accounts.
  • Communicated with patients about outstanding balances.
  • Notarized papers if needed.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Delivered timely and accurate charge submissions.
  • Filed and updated patient information and medical records.
  • Prepared billing statements for patients and verified correct diagnostic coding.
  • Posted payments and collections on regular basis.
  • Liaised between patients, insurance companies, and billing office.
  • Collected payments and applied to patient accounts.
  • Reviewed patient diagnosis codes to verify accuracy and completeness.
  • Reviewed patient records, identified medical codes, and created invoices for billing purposes.
  • Adhered to established standards to safeguard patients' health information.
  • Verified insurance of patients to determine eligibility.
  • Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
  • Entered invoices requiring payment and disbursed amounts via check, electronic transfer or bank draft.
  • Collaborated with customers to resolve disputes.
  • Generated monthly billing and posting reports for management review.
  • Utilized various software programs to process customer payments.
  • Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
  • Processed payment via telephone with focus on accuracy and efficiency.
  • Audited and corrected billing and posting documents for accuracy.
  • Handled account payments and provided information regarding outstanding balances.
  • Reconciled accounts receivable to general ledger.
  • Responded to customer concerns and questions on daily basis.
  • Kept vendor files accurate and up-to-date to expedite payment processing.
  • Followed all company policies and procedures to deliver quality work.
  • Maintained overall safe work environment with employee training programs and enforcement of safety procedures.
  • Educated staff on organizational mission and goals to help employees achieve success.
  • Monitored outstanding invoices and performed collections duties.

Patient Coordinator/Medical Biller

Dr. Donald K. Sanford MD
06.2016 - 05.2019
  • Verified insurance, billing and coding, scheduled patients.
  • Processed medical claims.
  • Developed payment plans.
  • Reviewed and resolved denied claims.
  • Prepared invoices.
  • Communicated with patients about outstanding balances.
  • Maintained confidentiality of patient data and condition to safeguard health information.
  • Explained upcoming treatment preparation, instructions, and other facts to patients.
  • Worked with patients to schedule tests and procedures.
  • Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
  • Applied administrative knowledge and courtesy to explain procedures and services to patients.
  • Worked with patients to ascertain issues and make referrals to appropriate specialists.
  • Greeted and assisted patients with check-in procedures.
  • Provided excellent customer service to patients and medical staff.
  • Processed payments using cash and credit cards, maintaining accurate records of transactions.
  • Prepared billing statements for patients and verified correct diagnostic coding.
  • Reviewed patient diagnosis codes to verify accuracy and completeness.
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Collected payments and applied to patient accounts.
  • Generated monthly billing and posting reports for management review.
  • Verified accuracy of accounts payable payments, resulting in 45% reduction in payment errors and check reissues.

Collections Coordinator and Notary Public

Rent2OwnHQ
11.2015 - 02.2017
  • Receive and process all tickets, tolls and payments, create and distribute invoices, assist customers with inspection sticker and car title questions, file title paperwork, manage files, order all office supplies, assist in scheduling office employees and serve as public notary.
  • Managed collection accounts, ensuring timely payments and resolving customer disputes.
  • Researched accounts and completed due diligence to resolve collection problems.
  • Monitored customer accounts to identify overdue payments and initiate collections processes.
  • Counseled debtors on payment options and arranged installment agreements.
  • Conducted research on customers to ensure accurate contact information was on file.
  • Worked in call center environment handling manual and automatically dialed outbound calls.
  • Drafted letters to delinquent customers to inform them of their past due balances.
  • Negotiated to collect balance in full.
  • Negotiated payment plans with customers in order to bring accounts current.
  • Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.
  • Verified accuracy of invoices, bills, and other financial documents prior to submission for payment processing.
  • Processed payments and applied to customer balances.
  • Utilized various software programs such as Microsoft Office Suite for daily tasks.
  • Provided backup to front desk to step in to assist with various tasks whenever employee was absent or at lunch.
  • Provided guidance to team members regarding collections policies and procedures.
  • Interceded between employees during arguments and diffused tense situations.
  • Maintained detailed records of collection activity and account information.
  • Completed bi-weekly payroll for 54 employees.
  • Communicated effectively with internal departments regarding status updates and resolution of customer inquiries or complaints.
  • Established relationships with external debt collectors for assistance in collecting unpaid balances.
  • Optimized organizational systems for payment collections, AP/AR, deposits, and recordkeeping.
  • Reviewed credit reports and determined appropriate course of action when necessary.
  • Developed strategies to reduce bad debt exposure and improve cash flow performance.
  • Analyzed financial data such as balance sheets, income statements, and other related documents.
  • Used skip tracing and other techniques to locate debtors.
  • Maintained high volume of calls and met demands of busy and productive group.
  • Used probing techniques to determine debtors' reasons for delinquency.
  • Trained new team members on scripts, company services, and collection strategies.

Medical Assistant Supervisor

San Hidalgo Family Practice
12.2008 - 03.2015
  • Front office and back-office tasks.
  • Scheduled appointments.
  • Answered multi-phone lines.
  • Data entry.
  • Ordered supplies.
  • Verifying patient insurance coverage is a critical step before appointments.
  • Managing referrals to specialists is an important task that ensures continuity of care.
  • Assisted in patient vitals.
  • Called and scheduled patients for additional testing and diagnostics at other medical facilities.
  • Called patients to remind them of office appointments.
  • Called and faxed pharmacies to submit prescriptions and refills.
  • Evaluated and interpreted laboratory results to determine diagnoses.
  • Demonstrated respect, friendliness and willingness to help wherever needed.
  • Gained extensive knowledge in data entry, analysis and reporting.
  • Worked effectively in fast-paced environments.
  • Strengthened communication skills through regular interactions with others.
  • Exercised leadership capabilities by successfully motivating and inspiring others.
  • Managed approximately 30 incoming calls, emails and faxes per day from customers.

Education

Bachelor of Science - Certified Public Accountant

South Texas College
09.2015

Diploma - Medical Assisting

Everest Institute
05.2008

High School Diploma -

Marque Learning Center
03.2008

Skills

  • Excel
  • Outlook
  • QuickBooks
  • EMR systems
  • Word
  • Medical Receptionist
  • Customer Service
  • Billing
  • Filing
  • Data Entry
  • Scheduling
  • Inventory
  • Clerical
  • Microsoft Word
  • Microsoft Excel
  • Management
  • Microsoft Office
  • Microsoft Suite 2010
  • Insurance Verification
  • HIPAA Compliance
  • Billing Support
  • Paperwork Coordination
  • Patient Relations
  • Mail Management
  • Payment Collection
  • Check-In Management
  • Schedule Coordination
  • Intake Form Processing
  • Information Documentation
  • Call Handling
  • Medical Terminology
  • Referral Verification
  • Medical Billing
  • Medical Charting
  • Records Management
  • Medical Transcription
  • Understanding of Medical Laws
  • Petty Cash Management
  • Patient Scheduling
  • Account Management
  • Workflow Optimization
  • Patient Callbacks
  • Inpatient Care
  • Insurance Claims
  • Appointment Setting
  • Records Maintenance
  • Medical Records Management
  • Co-Payment Collection
  • Front Desk Operations
  • Electronic Medical Records
  • HIPAA Guidelines
  • Appointment Scheduling
  • Outpatient Care
  • Claims review
  • Multitasking and organization
  • Electronic claims
  • Database systems
  • CPT code modifiers
  • Medical claims submission
  • Disability claims process
  • Medical terminology expert
  • Data entry
  • Accounts receivable
  • Claims processing
  • Billing and collection procedures
  • ICD-10
  • Electronic health record software
  • Insurance billing
  • Medical coding
  • Customer service
  • Medical billing
  • Work prioritization
  • Insurance verification
  • Critical thinking
  • HIPAA compliance
  • Medical terminology
  • Medical billing technology
  • CMS-1500 billing forms
  • Insurance claims processing
  • Patient billing
  • Chart auditing
  • Insurance collections
  • Teamwork and collaboration
  • Claim submission
  • Payment posting
  • HIPAA compliance certification
  • Balance reconciliation
  • Account management
  • Proficiency in Microsoft 365
  • Knowledgeable in Microsoft 365
  • Medicare and Medicaid process
  • Accounts receivable management
  • Account reconciliation

Accomplishments

  • Supervised team of 12 staff members.
  • Achieved a 48% increase in revenue through accurate and efficient claims and denials management highlights a significant success in optimizing the healthcare revenue cycle.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Documented and resolved patients collections which led to 33% increase in revenue.
  • Collaborated with team of 12 in the development of online training, software development, or other initiatives aimed at enhancing the skills.

Certification

  • Registered Clinical Medical Assistant (RCMA), 05/01/08
  • Certified Public Accountant in Accounting, 05/01/15
  • Driver's License

Timeline

Medical Biller Specialist

VRA, PC( Remote)
05.2019 - 02.2025

Patient Coordinator/Medical Biller

Dr. Donald K. Sanford MD
06.2016 - 05.2019

Collections Coordinator and Notary Public

Rent2OwnHQ
11.2015 - 02.2017

Medical Assistant Supervisor

San Hidalgo Family Practice
12.2008 - 03.2015

Bachelor of Science - Certified Public Accountant

South Texas College

Diploma - Medical Assisting

Everest Institute

High School Diploma -

Marque Learning Center

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Misty SpooresMedical Biller Specialist