Renita Hobbs
Macon,USA
Summary
Highly skilled healthcare professional with strong expertise in medical billing and coding. Offering over 15 years of experience in medical coding and billing. Skilled in accurately coding patient information and submitting claims for reimbursement. Committed to ensuring streamlined billing processes and optimizing revenue cycles for healthcare providers. Adept at accurately processing patient data and insurance claims while ensuring compliance with regulations. Strong focus on team collaboration and achieving results, adaptable to changing needs. Proficient in medical terminology, coding systems, and electronic health records, with reliable and efficient work ethic.
Overview
12
12
years of professional experience
Work History
Medical Biller And Coder
EVMS
04.2017 - 10.2024
- Ensured timely filing of all claims within established guidelines.
- Analyzed patient accounts for errors, inaccuracies or discrepancies in billing documentation.
- Filed and submitted insurance claims.
- Submitted claims to insurance companies electronically or by mail.
- Adhered strictly to HIPAA guidelines when handling confidential patient information.
- Provided customer service support to patients regarding billing inquiries.
- Assessed medical codes on patient records for accuracy.
- Maintained current CPT, HCPCS codes library as well as ICD-9, 10 CM diagnostic codes.
- Monitored aging accounts receivable report weekly to identify unpaid balances due.
- Developed an understanding of how various insurance plans process claims for reimbursement purposes.
- Resolved denied claims by researching payer requirements and preparing appeals.
- Documented and filed patient data and medical records.
- Interpreted physician orders, notes, lab results, radiology reports for appropriate code assignment.
- Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
- Reviewed medical records and identified diagnosis codes, procedures, services and supplies for coding.
- Identified trends in denials and worked collaboratively with clinic staff to reduce denials.
- Responded promptly to requests from insurance companies regarding clarification on claim submissions.
- Performed daily audits on all bills submitted for accuracy and completeness.
- Maintained up-to-date knowledge of coding regulations and changes in reimbursement policies.
- Reconciled accounts receivable to ensure accuracy of payments received.
- Reviewed medical records to meet insurance company requirements.
- Compiled and coded patient data using standard classification systems.
- Maintained positive working relationship with fellow staff and management.
- Entered patient insurance, demographic and health information into software and confirmed records.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
Claims Specialist
Medic Management Group
04.2024 - 09.2024
- Reduced errors in claims submissions through meticulous attention to detail and thorough review processes.
- Managed high volume of claims, consistently meeting deadlines without compromising accuracy or quality.
- Educated staff members on proper coding techniques through comprehensive training seminars.
- Monitored and updated claims status in claims processing system.
- Managed large volume of medical claims on daily basis.
- Followed up on denied claims to verify timely patient payment and resolution.
- Verified patient insurance coverage and benefits for medical claims.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Responded to correspondence from insurance companies.
- Developed strong relationships with healthcare providers to facilitate efficient information exchange regarding patient eligibility and benefits coverage.
- Monitored outstanding accounts receivable balances for trends that could indicate payer issues or potential collection problems.
- Expedited claim resolution times with proactive communication between patients, providers, and insurance companies.
- Achieved timely reimbursements for clients through keen understanding of insurance company protocols.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Prepared insurance claim forms or related documents and reviewed for completeness.
Claims Resolution Specialist II
Central Georgia Cancer Care
02.2022 - 04.2024
- Processed payments, refunds, and adjustments.
- Investigated and resolved customer inquiries related to the status of their claims.
- Analyzed claim documents, such as medical records, bills and invoices, to ensure accuracy of information.
- Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
- Ensured timely filing of all claims within established guidelines.
- Analyzed patient accounts for errors, inaccuracies or discrepancies in billing documentation.
- Submitted claims to insurance companies electronically or by mail.
- Adhered strictly to HIPAA guidelines when handling confidential patient information.
- Provided customer service support to patients regarding billing inquiries.
- Assessed medical codes on patient records for accuracy.
- Processed corrections and adjustments as needed to ensure accurate payment from third party payers.
- Monitored aging accounts receivable report weekly to identify unpaid balances due.
- Tracked details such as authorizations, pre-certifications or referrals required prior to service delivery.
- Developed an understanding of how various insurance plans process claims for reimbursement purposes.
- Expertly assigned charges and payments for medical procedures.
- Resolved denied claims by researching payer requirements and preparing appeals.
- Worked closely with physicians to obtain additional clinical information when needed for accurate coding assignments.
- Interpreted physician orders, notes, lab results, radiology reports for appropriate code assignment.
- Reviewed medical records and identified diagnosis codes, procedures, services and supplies for coding.
- Reduced errors in claims submissions through meticulous attention to detail and thorough review processes.
- Expedited claim resolution times with proactive communication between patients, providers, and insurance companies.
- Managed large volume of medical claims on daily basis.
- Verified patient insurance coverage and benefits for medical claims.
- Followed up on denied claims to verify timely patient payment and resolution.
- Responded to correspondence from insurance companies.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Posted payments to accounts and maintained records.
Insurance Customer Service Representative
Southampton Memorial Hospital
09.2012 - 04.2017
- Assisted with customer inquiries, complaints, and requests for information regarding insurance policies.
- Provided quotes on various types of insurance policies.
- Developed strong relationships with clients by providing exceptional customer service.
- Greeted customers and provided prompt, courteous service.
- Conducted follow-up calls to ensure satisfactory resolution of customer issues.
- Verified accuracy of customer data entered into the system.
- Responded promptly to emails and phone calls from customers seeking assistance.
- Performed administrative duties such as filing, scanning, faxing, copying documents.
- Facilitated payment processing for premium payments and renewals.
- Ensured compliance with company guidelines and regulatory standards when dealing with customers' accounts or policies.
- Attended training and educational seminars to enhance knowledge and credentials.
- Investigated discrepancies between actual charges and expected premiums.
- Collected payments, processed receipts and informed policyholders of outstanding balances.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Handled billing related activities focused on medical specialties.
- Coordinated discharge paperwork for admitted patients in accordance with hospital policies.
- Collaborated with other departments such as laboratory, radiology, and pharmacy when verifying patient information.
- Processed payments, collected co-payments and deposits from patients.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Answered telephones and directed calls to appropriate medical or administrative staff.
- Communicated with patients with compassion while keeping medical information private.
- Greeted patients, determined purpose of visit and directed to appropriate staff.
- Scheduled tests, lab work or x-rays for patients based on physician orders.
Education
Associate Of Applied Science - Health Management And Clinical Assistance
Colorado Technical University
Colorado Springs, CO08.2025
Certificate of Technical Studies - Medical Insurance Billing
Darton State College
Albany, GA10.2004
Skills
- Documentation Skills
- Customer Relations
- Claims Investigation
- Benefits Coordination
- Claims Processing
- Payment Posting
- Insurance Verification
- Revenue Cycle Management
- Data Entry
- ASC Coding
- Workflow Management
- Coding Error Resolution
- ICD-10 proficiency
- Denial management
- Claim submission
- CPT coding
- Insurance verification
- Revenue cycle management
- Payment posting
- Medicare and medicaid billing
- Commercial insurance billing
- Medical coding expertise
- Claims processing
- Proficiency in EPIC, Centricity, Meditrac, AllScripts, SAP, Athena, Theraworks
Timeline
Claims Specialist
Medic Management Group
04.2024 - 09.2024
Claims Resolution Specialist II
Central Georgia Cancer Care
02.2022 - 04.2024
Medical Biller And Coder
EVMS
04.2017 - 10.2024
Insurance Customer Service Representative
Southampton Memorial Hospital
09.2012 - 04.2017
Associate Of Applied Science - Health Management And Clinical Assistance
Colorado Technical University
Certificate of Technical Studies - Medical Insurance Billing
Darton State College
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