Summary
Overview
Work History
Education
Skills
Timeline
Generic

Rhonda Roane

Orlando,FL

Summary

Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

14
14
years of professional experience

Work History

Senior Medical Billing Specialist

Sarnova Health
02.2020 - 04.2025
  • 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.
  • Liaised between patients, insurance companies, and billing office.
  • Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Prepared billing correspondence and maintained database to organize billing information.
  • Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Located errors and promptly refiled rejected claims.
  • Researched CPT and ICD-9/10 coding discrepancies for compliance and reimbursement accuracy.
  • Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
  • Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
  • Precisely evaluated and verified benefits and eligibility.
  • Reviewed patient records, identified medical codes, and created invoices for billing purposes.
  • Prepared billing statements for patients and verified correct diagnostic coding.
  • Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
  • Reviewed patient diagnosis codes to verify accuracy and completeness.
  • Collected payments and applied to patient accounts.

Healthcare Customer Service Representative

Methodist Healthcare
03.2011 - 01.2020
  • Streamlined appointment scheduling process by utilizing advanced software tools, optimizing time management for both patients and medical professionals.
  • Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
  • Expanded knowledge on medical terminology and insurance policies through continuous learning initiatives, enhancing accuracy in communication with clients.
  • Increased first-call resolution rates by carefully listening to customers'' needs and providing accurate information based on their inquiries.
  • Met customer call guidelines for service levels, handle time and productivity.
  • Collaborated with healthcare providers to understand and address common eligibility issues.
  • Conducted thorough eligibility assessments, ensuring compliance with federal and state Medicaid policies.
  • Utilized advanced computer systems to track applicant data, generating accurate reports for internal review as needed.
  • Maintained up-to-date knowledge of Medicaid,Medicare and HMO regulations, ensuring accurate eligibility determinations.
  • Generated reports to track insurance verifications and claim progress.
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Updated patient records with accurate, current insurance policy information.
  • Posted payments to accounts and maintained records.
  • Made contact with insurance carriers to discuss policies and individual patient benefits.
  • Achieved insurance pre-authorizations to enable timely patient procedures.
  • Ensured accuracy in patient insurance information by meticulously verifying details, leading to reduction in claim denials.
  • Expedited patient registration process by efficiently validating eligibility for various insurance plans.
  • Collaborated with healthcare providers to ensure that insurance coverage met needs of patient treatments.
  • Managed high-volume insurance verifications within pressured timeframes for productive medical operations.

Education

Medical Billing And Coding Diploma

American Academy of Professional Coders
Online
12-2025

High School Diploma -

Evans High School
Orlando, FL
05-2003

Skills

  • ICD-10 proficiency
  • HIPAA compliance
  • Denial management
  • Accounts payable
  • Claim submission
  • Insurance verification
  • Medicare,Medicaid,Commerical and HMO process
  • Patient billing
  • Payment posting
  • Quality-oriented team player
  • CPT knowledge
  • Insurance claims processing
  • Data entry
  • Claims processing
  • Multitasking and organization
  • ICD-10 coding
  • Medical terminology
  • Medical billing
  • Insurance billing
  • Patient confidentiality
  • Insurance coverage verification
  • Prior authorization processing
  • Referral coordination
  • Patient registration

Timeline

Senior Medical Billing Specialist

Sarnova Health
02.2020 - 04.2025

Healthcare Customer Service Representative

Methodist Healthcare
03.2011 - 01.2020

Medical Billing And Coding Diploma

American Academy of Professional Coders

High School Diploma -

Evans High School

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