Salome Sea
Killeen
Summary
Efficient Medical Biller with solid background in medical billing processes. Adept at managing patient accounts and ensuring accurate claim submissions. Demonstrated analytical skills and attention to detail in resolving billing discrepancies and communicating with insurance companies. Experienced with Medicare, Medicaid and commercial insurance. Familiar with ICD 9/10, CPT and HCPCS codes.
Overview
14
14
years of professional experience
Work History
Medical Insurance Biller
Zoll Data Systems/Digitech Computer
Remote
06.2024 - Current
- Verified insurance eligibility and benefits for emergency medical services/ambulance services.
- Processed medical claims using ICD-10 and CPT coding standards
- Generated monthly reports on accounts receivable and collection rates
- Maintained patient accounts and posted payments accurately
- Audited billing records to ensure HIPAA compliance requirements
- Bill for Medicare, Medicaid and Commerical insurance
- Managed billing cycles to ensure timely processing and accuracy of claims.
- Analyzed payment discrepancies to resolve issues and improve revenue collection.
Claims Examiners
Care National
Remote
05.2022 - 02.2024
- Reviewed medical claims for accuracy and compliance with policy guidelines
- Processed insurance claims within established turnaround time standards
- Identified fraudulent claim patterns through systematic data analysis
- Maintained detailed records of claim decisions and communications
- Collaborated with healthcare providers to resolve claim discrepancies
- In-patient billing for hospital
- Use Epic software
- Reviewed and processed complex insurance claims, ensuring compliance with regulatory requirements.
- Conducted audits of claims to identify discrepancies and implement corrective actions.
In-Home Care Providers
Self Employed
6509 Alabaster Dr, Killeen, TX 76542
05.2017 - 06.2020
- Administered medications and monitored vital signs for elderly clients
- Coordinated medical appointments and transportation for homebound patients
- Prepared nutritious meals accommodating dietary restrictions and preferences
- Provided companionship and emotional support to isolated seniors
- Assisted clients with personal hygiene and mobility exercises
- Maintained detailed care logs documenting daily activities and health changes
Accounts Receivable Clerks
Integrated Health Management
3800 S W S Young Drive, # 201 Killeen, TX 76542
09.2016 - 04.2017
- Processed daily invoice batches and payment applications in accounting system
- Reconciled customer accounts to identify and resolve billing discrepancies
- Maintained aging reports and followed up on overdue accounts
- Responded to patient inquiries regarding billing statements and payment options
- Generated monthly financial reports for accounts receivable portfolio
- Coordinated with insurance providers to verify coverage and process claims
EMS Billing Specialists
City of Killeen
5201 S. 28th Street Killeen, TX 76541
02.2012 - 08.2012
- Processed monthly utility billing statements for residential and commercial accounts
- Reconciled payment discrepancies and resolved customer billing inquiries
- Maintained accurate records of account adjustments and payment transactions
- Updated customer account information in municipal billing database system
- Coordinated with multiple city departments to verify service usage data
- Generated detailed reports on outstanding balances and collection activities
- Processed and reviewed billing statements for accuracy and compliance with city regulations.
- Coordinated with various departments to resolve billing discrepancies and enhance service delivery.
- Developed training materials for new staff, improving onboarding efficiency and knowledge retention.
- Monitored billing cycles to ensure timely invoicing and collections, enhancing cash flow management.
- Implemented improvements in billing workflows that increased operational efficiency by reducing processing time.
- Mentored junior billing staff of 8 billers, fostering a culture of continuous improvement and professional development.
- Researched and resolved billing discrepancies to enable accurate billing.
- Worked with multiple departments to check proper billing information.
- Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
- Emergency Medical Service billing for the City of Killeen
- Experience with billing Medicare, Medicaid and commerical insurance.
Education
Associate of Arts - Business Fundamentals
University of Phoenix
Phoenix, AZ01.2020
Skills
- Customer support expertise
- Effective leadership
- Strong verbal and non-verbal communication
- Accounts receivable processing
- Dispute resolution strategies
- Relational database expertise
- Health insurance verification
- Debt collection oversight
- Medical language proficiency
- Medicare and Medicaid knowledge
- Organizational growth
Meticulous attention to detail
- Medical claims processing
- Payment posting
- ICD-9/10
- HIPAA compliance
- CPT knowledge
- Operations support
- Billing codes
- CPT code modifiers
- Electronic claims
- Experienced in ambulance/EMS, out-patient, physician and chiropractic billing
- Medical Insurance and disability claims process
- Medical billing software proficiency such as EPIC, MediSoft, eClinicalWorks, Sweetwater, NextGen
Timeline
Medical Insurance Biller
Zoll Data Systems/Digitech Computer
06.2024 - Current
Claims Examiners
Care National
05.2022 - 02.2024
In-Home Care Providers
Self Employed
05.2017 - 06.2020
Accounts Receivable Clerks
Integrated Health Management
09.2016 - 04.2017
EMS Billing Specialists
City of Killeen
02.2012 - 08.2012
Associate of Arts - Business Fundamentals
University of Phoenix