Sadiyah Washington
Augusta,GA
Summary
Organized Medical Biller thoroughly versed in medical coding and HIPAA requirements. Personable professional with 3 years of hands-on experience claiming refunds, reviewing claims and maintaining billing reports. Accommodating and helpful team player proficient in job-related billing software.
Overview
3
3
years of professional experience
Work History
Medical Billing Specialist
Southeast Retina Center
Augusta, GA
03.2021 - 01.2024
- Provided customer service support to patients who had questions about their bills or payments due.
- Updated patient accounts with information obtained from internal departments or external sources.
- Processed credit card payments from patients in accordance with office policy.
- Worked closely with clinical staff to ensure accurate coding practices were followed.
- Researched complex billing issues involving multiple providers or services rendered over a period of time.
- Reviewed and verified benefits and eligibility with speed and precision.
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Answered phone calls from customers regarding their accounts and provided timely resolution.
Authorization Specialist
Southeast Retina Center
Augusta, GA
03.2021 - 01.2024
- Provided customer service to internal and external customers related to authorization requests.
- Reviewed authorization requests for accuracy and completeness.
- Researched patient eligibility, coverage information, and benefit levels.
- Verified insurance authorizations with payers via telephone or web-based systems.
- Maintained current knowledge of applicable regulations, laws, and standards.
- Processed prior authorization requests in accordance with departmental guidelines.
- Tracked authorization statuses using electronic databases or manual filing systems.
- Prepared appeal letters on behalf of clients when necessary to resolve disputes with insurers.
- Ensured timely submission of accurate documentation to support payment of services rendered by providers.
- Participated in meetings with staff members from other departments such as billing and coding teams to provide clarification on policies related to authorizations.
- Advised medical staff on the status of authorization requests.
Patient Financial Counselor
Southeast Retina Center
Augusta, GA
03.2021 - 01.2024
- Counseled patients on financial obligations associated with their medical care.
- Analyzed patient account data and determined payment plans based on individual needs.
- Developed rapport with patients to discuss sensitive financial matters in a professional manner.
- Assisted patients in understanding the details of their bills, including deductibles and co-pays.
- Provided clear explanations of billing policies and procedures to both internal and external customers.
- Performed follow up calls to collect outstanding balances from patients who were unable to make payments at time of service.
- Collaborated with hospital staff members to resolve complex billing issues.
- Processed credit card payments accurately and securely.
Insurance Claims Specialist
Southeast Retina Center
Augusta, GA
03.2021 - 01.2024
- Submitted claims to insurance companies.
- Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Collaborated closely with other departments to resolve claims issues.
- Submitted refund requests for claims paid in error.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Submitted appeals using provider portals and phone communication.
Education
Medical Billing & Coding Certification - Medical Billing & Coding
Miller-Motte College
Augusta, GA06.2021
High School Diploma -
Georgia Cyber Academy
Atlanta, GA05.2015
Skills
- Bill Payment
- Files and Records Management
- Generally Accepted Accounting Principles (GAAP)
- Quality-Oriented Team Player
- Teamwork and Collaboration
- Multitasking and Organization
- HIPAA Compliance Certification
- Claims Review
- Clerical Support
- Electronic Claims
- ICD-10 Coding
- CMS-1500 Billing Forms
- Medicaid and Medicare Knowledge
- Electronic Health Record Software
- HIPAA Compliance
- Medical Billing
- Medical Coding Understanding
- Insurance Claims Processing
- Billing and Collection Procedures
- Insurance Verification
- Medical Terminology
- Insurance Claims
Timeline
Medical Billing Specialist
Southeast Retina Center
03.2021 - 01.2024
Authorization Specialist
Southeast Retina Center
03.2021 - 01.2024
Patient Financial Counselor
Southeast Retina Center
03.2021 - 01.2024
Insurance Claims Specialist
Southeast Retina Center
03.2021 - 01.2024
Medical Billing & Coding Certification - Medical Billing & Coding
Miller-Motte College
High School Diploma -
Georgia Cyber Academy
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