Senior medical billing professional with deep expertise in coding, billing software, and insurance claims management. Strong focus on team collaboration and achieving results, adapting flexibly to changing needs. Reliable and detail-driven, ensuring accuracy in all financial transactions and compliance with regulatory requirements. Skilled in problem-solving and streamlining billing processes for optimal efficiency.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Senior Medical Billing Specialist
Integrity Billing Solutions
09.2023 - 01.2026
Contributed to team success by actively participating in staff meetings, offering insights into improving workflows within the department.
Ensure that all services rendered by healthcare providers were correctly documented and billed according to the appropriate CPT and ICD-10 coding standards.
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.
Provided exceptional customer service to patients, addressing their concerns regarding insurance claims or billing issues with empathy and professionalism.
Established positive relationships with insurance companies, facilitating open communication lines for efficient claim processing.
Resolved coding discrepancies through in-depth analysis and collaboration with physicians, ensuring appropriate reimbursement for services rendered.
Analyzed financial reports to identify trends and areas for improvement in the overall revenue cycle process.
Medical Billing Associate
St. Luke's Cataract & Laser Institute
02.2024 - 03.2025
Answered high volume inbound calls from patients, insurance companies, and other stakeholders, addressed inquiries, and resolved billing-related issues promptly.
Communicated effectively with various departments via email to address and rectify any billing discrepancies or concerns, ensuring seamless operational workflow.
Reviewed and analyzed patient accounts to provide clear explanations of their Explanation of Benefits (EOB), ensuring patients understood their billing statement and charges.
Facilitated payment collections by processing payments over the phone and setting up payment plans tailored to patients' needs. Managed and addressed issues related to bad debts to maintain financial health.
Prepared, verified, and dispatched itemized billing statements to patients, ensuring all charges were accurate.
Accurately posted and reconciled payments from various payers, including insurance companies and patients, ensuring all payments were applied to the correct accounts.
Monitored and resolved discrepancies in payments, identifying underpayment or overpayment and taking appropriate corrective actions.
Maintained accurate records of customer payments.
Used data entry skills to accurately document and input statements.
Responded to customer concerns and questions on daily basis.
Excellent communication skills, both verbal and written.
Payment Poster – Contract
Baptist Health Systems
06.2022 - 09.2023
Proactively identified potential underpayments from insurers and took appropriate actions to rectify discrepancies swiftly.
Optimized payment allocation processes, resulting in decreased time spent on manual adjustments.
Maintained compliance with HIPAA regulations while handling sensitive patient information during payment posting tasks.
Processed payments that had been received from insurance companies and Medicare.
Increased accuracy of patient account balances by diligently applying payments according to insurance guidelines.
Communicated effectively with others through active listening and dynamic interpersonal skills.
Medical Billing Associate
Advocate Health Partners
07.2022 - 06.2023
Handled personal injury verifications and procedure estimates.
Answered inbound telephone calls and verified insurance coverage.
Billed claims to correct providers, appeals, and denials and assisted with correcting diagnosis codes on super bills.
Entered old charges from RXNT to Kareo system.
Medical Billing Specialist
Suncoast Center Inc.
01.2022 - 06.2022
Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
Filed and updated patient information and medical records.
Communicated with insurance providers to resolve denied claims and resubmitted.
Collected payments and applied to patient accounts.
Liaised between patients, insurance companies, and billing office.
Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
Streamlined billing processes by implementing efficient workflows and utilizing advanced software tools.
Served as a subject matter expert on medical billing matters, providing guidance to colleagues on complex cases or unique situations.
Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
Efficiently processed refunds or adjustments for patients when necessary, ensuring accuracy and compliance with company policies.
Billing Specialist – Remote
BayCare Health Care Systems
06.2021 - 12.2021
Researched and resolved billing discrepancies to enable accurate billing.
Reduced errors in financial records by conducting regular audits of billed accounts.
Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
Maintained detailed records of each account''s payment history, providing easy access to information for audit and analysis purposes.
Identified, researched, and resolved billing variances to maintain system accuracy and currency.
Worked with multiple departments to check proper billing information.
Maximized revenue potential by identifying and resolving under-billed accounts.
Strengthened client relationships through effective communication regarding billing issues and concerns.
Contributed to improved financial reporting by reconciling discrepancies between invoiced amounts and actual payments received.
Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
Ensured compliance with industry regulations by staying up-to-date on changes in billing rules and guidelines.
Patient Account Representative / Medical Billing – Contract
Change Healthcare
12.2019 - 08.2020
Reduced outstanding balances by implementing effective collection strategies tailored to individual patients'' needs.
Provided exceptional customer service, handling sensitive patient situations with professionalism and empathy.
Demonstrated adaptability in navigating complex payer guidelines to maximize reimbursement opportunities for the organization.
Posted payments and processed refunds.
Negotiated payment plans with patients experiencing financial difficulties, supporting them in meeting their obligations without undue stress.
Ensured compliance with healthcare regulations while processing claims and managing patient accounts.
Worked with outside entities to resolve issues with billing, claims, and payments.
Collaborated with the medical staff to ensure proper documentation and coding for accurate billing.
Monitored flags and resolved urgent items with accuracy and efficiency.
Patient Account Representative – Contract
GAFFEY Healthcare
09.2018 - 01.2019
Reconciled statements with patient records.
Enhanced patient satisfaction by promptly addressing inquiries and resolving account issues.
Facilitated smooth communications between patients, providers, and insurers, fostering an atmosphere of trust and collaboration.
Identified trends in unpaid accounts, developing targeted solutions for improved revenue recovery.
Streamlined billing processes for increased efficiency in managing patient accounts.
Maintained accurate records of all transactions, ensuring timely payments from patients and insurance providers.
Achieved a significant reduction in aged accounts receivable through diligent follow-up efforts with both patients and insurers.
Developed strong relationships with key contacts at insurance companies to expedite resolution of claim disputes or other account-related issues.
Maintained office inventory and organized supplies for efficiency and expected needs.
Utilized computer programs to create invoices, letters, and other documents.
Conducted regular audits of patient accounts, identifying discrepancies and rectifying errors as needed.
Assisted colleagues during peak periods or absences, showcasing teamwork skills while maintaining personal workload demands efficiently.
Member Services Representative / Customer Service
Molina Healthcare
10.2017 - 09.2018
Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
Responded to customer concerns with friendly and knowledgeable service and remedied issues promptly and effectively.
Accepted payments and updated accounts with latest information.
Operated in dynamic, high-volume environments to provide skilled assistance to more than 80 customers each day.
Increased customer retention with exceptional interpersonal skills and proactive problem-solving abilities.
Contributed to positive team morale by fostering an inclusive work environment that encouraged collaboration amongst colleagues from diverse backgrounds and skill sets.
Patient Account Representative
Navigant Cymetrix Corporation
04.2015 - 09.2017
Prepared reports detailing billing actions, flags, and other key information.
Electronically submitted bills according to compliance guidelines.
Responded to patient, family, and external payer inquiries.
Promoted a positive work environment by actively participating in team meetings and contributing ideas for process improvements.
Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
Educated patients on financial policies, promoting understanding of their responsibilities within the healthcare system.
Contacted patients after insurance was calculated to obtain payments.
Promptly received and forwarded incoming communications, such as phone calls, emails, and letters, to appropriate staff.
Input data into spreadsheets and databases.
Created and maintained detailed records of all office activities.
Answered and managed incoming and outgoing calls while recording accurate messages for distribution to office staff.
Patient Account Representative
Convergent
09.2013 - 03.2015
Enhanced the accuracy of billing processes for more successful payment outcomes.
Reduced outstanding balances by identifying and resolving discrepancies in patient accounts.
Utilized advanced software tools to track overdue payments and update account information accurately.
Maintained detailed records of all collection activities, ensuring thorough documentation for future reference.
Educated patients on available financial assistance programs, facilitating access to necessary resources.
Assisted in the development of policies and procedures related to patient account collections, contributing to organizational efficiency and effectiveness.
Negotiated payment plans with patients, ensuring timely payments and improved overall collection rates.
Improved patient account collections by implementing efficient tracking and follow-up procedures.
Ensured compliance with HIPAA regulations throughout all aspects of the patient account collection process.
Managed a high volume of patient accounts, consistently meeting or exceeding performance targets for collections activity.
Streamlined account management processes, increasing efficiency and accuracy in tracking payments.
Monitored aging reports to identify delinquent accounts for appropriate action.
Collaborated with insurance companies to ensure proper reimbursement for services rendered.
Education
Associate of Science Degree - Medical Billing and Coding
Ultimate Medical Academy
Tampa, FL
12-2025
Diploma - Medical Billing and Coding
Ultimate Medical Academy
Tampa, FL
06-2024
Skills
Revenue cycle management
Team collaboration aptitude
Patient confidentiality practices
Denial management strategies
Organizational growth
Analytical thinking capacity
Healthcare reimbursement models
HIPAA compliance awareness
Medical terminology fluency
Electronic health records experience
Claims processing proficiency
HCPCS level II coding
ICD-10 knowledge
Medical billing software mastery
Medical coding expertise
Anatomy and physiology
Medicare and medicaid regulations
Payment posting accuracy
Customer service
Certification
High Academic Honors Recognition / Dean's List / Member of Alpha Beta Kappa (ABK) Honor Society.
Ultimate Medical Academy – HIPAA Essentials for Healthcare Professionals Certificate.
American Academy of Professional Coders, AAPC Member
Timeline
Medical Billing Associate
St. Luke's Cataract & Laser Institute
02.2024 - 03.2025
Senior Medical Billing Specialist
Integrity Billing Solutions
09.2023 - 01.2026
Medical Billing Associate
Advocate Health Partners
07.2022 - 06.2023
Payment Poster – Contract
Baptist Health Systems
06.2022 - 09.2023
Medical Billing Specialist
Suncoast Center Inc.
01.2022 - 06.2022
Billing Specialist – Remote
BayCare Health Care Systems
06.2021 - 12.2021
Patient Account Representative / Medical Billing – Contract
Change Healthcare
12.2019 - 08.2020
Patient Account Representative – Contract
GAFFEY Healthcare
09.2018 - 01.2019
Member Services Representative / Customer Service
Molina Healthcare
10.2017 - 09.2018
Patient Account Representative
Navigant Cymetrix Corporation
04.2015 - 09.2017
Patient Account Representative
Convergent
09.2013 - 03.2015
Associate of Science Degree - Medical Billing and Coding
Senior Medical Billing Specialist at Premier Orthopedics and Sports MedicineSenior Medical Billing Specialist at Premier Orthopedics and Sports Medicine