Sharon Sanders
Summary
Detail-oriented Medical Billing Specialist with extensive experience in verification processes, claims processing, and patient data management. Proven ability in resolving discrepancies and ensuring compliance with insurance regulations.
Overview
30
30
years of professional experience
Work History
Medical Billing/Data Entry/Insurance Verification Specialist
Conrad Pearson Clinic
Germantown, Tennessee
1996.06 - Current
- Verified patient insurance coverage and eligibility for clinic services.
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
- Reviewed and updated patient records to enhance accuracy of billing and claims processing.
- Reviewed and updated patient records to ensure accurate billing and claims processing.
- Identified discrepancies in patients' insurance coverage, ensuring precision in data entry and minimizing claim rejections.
- Resolved discrepancies in patient information through effective communication with insurance providers.
- Resolved insurance-related issues and discrepancies to prevent claim denials.
- Utilized electronic health record systems for efficient data management and retrieval.
- Updated patient and insurance data in the electronic health record system for accuracy. and input changes into company computer system.
- Maintained documentation on pre-authorization requests, denials, and appeals to support compliance and operational efficiency.
- Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
- Maintained up-to-date knowledge of insurance policies, including Medicare and Medicaid.
- Coordinated with the billing department to ensure correct insurance information is applied to claims.
- Worked with billing specialists and medical coders to clarify discrepancies in patients' insurance information.
- Assisted patients in comprehending insurance benefits and available coverage options.
- Assisted patients in understanding their insurance benefits and coverage options.
- Contacted patients to confirm demographic information and communicate financial responsibilities.
- Contacted patients to arrange payment arrangements for deductible and out-of-pocket liability.
- Communicated with patients with compassion while keeping medical information private.
- Interpreted Explanation of Benefits statements from various insurers and communicated relevant information with other departments as needed.
- Trained new team members on verification procedures and best practices.
- Processed medical payments accurately and efficiently for healthcare claims.
- Utilized billing software to manage payment posting and tracking tasks.
- Reconciled accounts to maintain accurate financial records and reporting.
- Received payments from insurance providers, handled Medicare packages and completed immediate processing.
- Handled all electronic and manual payments and adjustments, ensuring that data was accurately posted.
- Maintained accurate records of all payments in a secure and organized filing system. of all payments posted in an organized filing system.
- Followed up on pending claims that have not been paid by third-party insurers within specified timeframes.
- Followed up on pending claims that have not been paid by third-party insurers within specified timeframes.
Education
Medical Billing Coding
Conorde Career College
Memphis, TN1994-05
Skills
- Claims processing
- Medical billing software
- Patient data management
- Verification processes
- Explanation of benefits
- Insurance compliance
Timeline
Medical Billing/Data Entry/Insurance Verification Specialist
Conrad Pearson Clinic
1996.06 - Current
Medical Billing Coding
Conorde Career College