Rhonda Roane
Orlando
Summary
Medical billing professional with strong focus on accuracy and efficiency in processing healthcare claims. Demonstrates thorough understanding of insurance guidelines and billing procedures. A reliable team player who adapts to changing needs and is committed to achieving optimal results through collaboration and attention to detail.
Overview
20
20
years of professional experience
Work History
Medical Billing Specialist
Heart of The Rockies Regional Medical Center
02.2014 - 01.2026
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
- Processed Claims entries with an average of 50-100 claims per day.
- Contacted various ordering physicians to obtain the patient's medical records.
- Processed medical claims efficiently, ensuring compliance with regulations and payer guidelines.
- Reviewed and corrected billing discrepancies to enhance accuracy in patient accounts.
- Entered CPT codes and patient information into billing software.
- Reviewed and validated accuracy of charges including dates of service, services provided, location and provider signature.
- Completed and submitted CMS-1500 & UB-04 Forms.
- Connected with Insurance and patient aging to resubmit insurance claims when necessary.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Processed authorization requests ensuring compliance with company protocols.
- Resolved discrepancies in authorizations by coordinating with internal teams for accurate data input.
- Processed and posted payments accurately to patient accounts using electronic health record systems.
- Resolved discrepancies in payment postings through thorough investigation of billing records.
- Maintained up-to-date knowledge of insurance policies and payment procedures to enhance accuracy.
Senior Insurance Verification Specialist
Methodist Healthcare
Houston, TX
05.2006 - 02.2014
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Posted payments to accounts and maintained records.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Updated patient records with accurate, current insurance policy information.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Generated reports to track insurance verifications and claim progress.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Processed medical insurance claims and payments.
- Prepared and processed patient referrals and transfer requests.
- Assisted with medical coding and billing tasks.
- Accurately posted payments and adjustments both electronically and manually.
- Identified overpayments and processed refunds for insurance carriers and patients.
- Processed payments that had been received from insurance companies and Medicaid, Medicare.
Education
Certificate - Certified Professional Coder (CPC)
AHIMA
12-2026
High School Diploma - undefined
Evans High School
Orlando, FL05.2003
Skills
- HIPAA Compliance
- Medical Payment Posting
- Medical Claims Submission
- Medical Insurance Verification
- Medical Billing And Coding Knowledge
- CPT/ICD-10 Knowledge
- Medicare,Medicaid and Managed Care Knowledge
- Commercial and Private Insurance Knowledge
- Electronic Health Record Software
- Reimbursements
- CMS-1500 /UB-4 Billing Forms
- Medical Terminology
Timeline
Medical Billing Specialist
Heart of The Rockies Regional Medical Center
02.2014 - 01.2026
Senior Insurance Verification Specialist
Methodist Healthcare
05.2006 - 02.2014
High School Diploma - undefined
Evans High School
Certificate - Certified Professional Coder (CPC)
AHIMA