Rushon Howard
Tallahassee,FL
Summary
Results-driven Medical Billing Specialist with extensive experience at North Florida Medical Center. Expert in CPT coding and insurance claims processing, achieving over 98% accuracy. Demonstrates exceptional problem-solving and effective communication skills, ensuring timely resolution of claims and enhancing patient satisfaction. Committed to maintaining HIPAA compliance and financial reporting accuracy.
Overview
16
16
years of professional experience
Work History
Medical Insurance Billing Associate
North Florida Medical Center
Tallahassee, FL
06.2023 - Current
- Demonstrated proficiency in CPT, ICD-10, and HCPCS coding systems.
- Managed timely billing and claims processing for insurance carriers.
- Executed resubmissions and appeals for claims, generating daily reports.
- Performed electronic billing for Commercial, Medicare, and Medicaid accounts.
- Posted payments from EOBs and ERAs while following up on delinquent patient accounts.
Transaction Processor (Remote)
NTT DATA Services
Plano, TX
10.2020 - 06.2023
- Adjudicated medical claims (CPT, ICD-10, HCPCS) with high accuracy (e.g., ≥98%) and processed high volumes (50–100+ per day).
- Verified patient eligibility and insurance details, significantly reducing claim denials.
- Reviewed documentation for completeness and ensured HIPAA compliance.
- Communicated with providers, payors, and patients to resolve issues and speed up appeals cycles.
- Tracked claim statuses, initiated appeals, and recovered substantial underpayments (e.g., $500K+).
- Utilized EHR/EMR systems (Epic, Cerner, Meditech, QNXT, eClinicals) and HIPAA-compliant EDI formats.
Medical Billing Specialist
Tallahassee Memorial Hospital
Tallahassee, FL
07.2017 - 09.2020
- Handling patient queries, updating returned mail, and processing claims for inpatient and outpatient services.
- Make adjustments to determine allowable costs for claims (Medicare, Medicaid, Tricare, HMOs, PPOs, and HSAs)
- Follow-up on claims, payment posting, and accounts receivable management.
- Analyzes documentation to support codes/DRGs and abstracted data (e.g., discharge disposition) for inpatient records for multiple facilities using ICD-10-CM and ICD-10-PCS
Claims Examiner II
Capital Health Plan/Blue Cross Blue Shield
Tallahassee, FL
10.2009 - 06.2017
- Processed insurance claims on UB and HCFA forms with high precision and accuracy.
- Executed coding of claims while efficiently posting ERAs/EOBs.
- Entered data into computer systems to effectively track claim status.
- Ensured quality and security of health information in paper and electronic formats.
- Applied extensive knowledge in Behavioral Health, Auto, and Commercial claims across various service networks.
Education
Diploma - Medical Billing And Coding
Ultimate Medical Academy
Tampa, FL06-2025
High School Diploma -
Rickards High School
Tallahassee, FLSkills
- Virtual communication tools
- Electronic medical records systems
- Medical billing and coding
- Financial management
- Insurance claims processing
- Microsoft Office proficiency
- HIPAA compliance
- Utilization management
- Attention to detail
- Effective communication
- Customer service excellence
- Problem solving skills
- CPT coding proficiency
- Collections management
- Dispute resolution strategies
- QuickBooks expertise
- Invoice processing skills
- Professional ethics
- Payment processing efficiency
- Financial reporting accuracy
- Conflict resolution techniques
- Cash posting accuracy
- Monthly billing oversight
Timeline
Medical Insurance Billing Associate
North Florida Medical Center
06.2023 - Current
Transaction Processor (Remote)
NTT DATA Services
10.2020 - 06.2023
Medical Billing Specialist
Tallahassee Memorial Hospital
07.2017 - 09.2020
Claims Examiner II
Capital Health Plan/Blue Cross Blue Shield
10.2009 - 06.2017
Diploma - Medical Billing And Coding
Ultimate Medical Academy
High School Diploma -
Rickards High School
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