Sharonda Mackey
Columbus,OH
Summary
Skilled Medical Billing Specialist with background in accurate coding, claims processing and managing patient accounts. Showcased proficiency in medical software systems, healthcare regulations, and insurance policies. Proven ability to streamline billing procedures leading to increased productivity and improved revenue cycle management. Known for strong problem-solving skills and commitment to maintaining confidentiality in handling sensitive patient information.
Overview
23
23
years of professional experience
Work History
Medical Billing Specialist
PrimaryOne Health
Columbus, OH
07.2024 - Current
- Provided customer service support to patients who had questions about their bills or payments due.
- Researched complex billing issues involving multiple providers or services rendered over a period of time.
- Generated monthly invoices for patients based on services provided according to established fee schedules.
- Assisted with the reconciliation of accounts receivable ledgers at month-end close process.
- Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
- Updated patient accounts with information obtained from internal departments or external sources.
- Processed credit card payments from patients in accordance with office policy.
- Reviewed patient records for accuracy and completeness of information in medical billing system.
- Resolved discrepancies between insurance companies and patients regarding payment of bills.
- Verified the accuracy of claim data prior to submission to insurance carriers.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
- Maintained detailed records of all billing activities including denials, adjustments, and payments received.
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Completed appeals and filed and submitted claims.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Posted charges, payments and adjustments.
- Reviewed and verified benefits and eligibility with speed and precision.
- Applied payments, adjustments, and denials into medical manager system.
- Precisely completed appropriate paperwork and system entry regarding claims.
- Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
- Maintained timely and accurate charge submission through electronic charge capture, including billing, and account receivables (BAR) system and clearing house.
- Posted charges, payments, and write-ups for cardiovascular procedures.
- Accurately coded diagnostics and prepared billing statements for patients.
Medical Billing Specialist
Columbus Area Integrated Health Services Inc.
Columbus, OH
05.2018 - 03.2019
- Updated patient accounts with information obtained from internal departments or external sources.
- Monitored aging accounts receivable balances ensuring timely resolution of outstanding balances.
- Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
- Worked closely with clinical staff to ensure accurate coding practices were followed.
- Reviewed patient records for accuracy and completeness of information in medical billing system.
- Prepared daily reports summarizing payments received from insurers or other sources.
- Verified the accuracy of claim data prior to submission to insurance carriers.
- Maintained detailed records of all billing activities including denials, adjustments, and payments received.
- Posted charges, payments and adjustments.
- Collaborated closely with other departments to resolve claims issues.
- Precisely completed appropriate paperwork and system entry regarding claims.
- Submitted refund requests for claims paid in error.
- Kept detailed and accurate documentation of payments, charges and write-ups of cardiovascular procedures.
- Reviewed claims for coding accuracy.
- Answered customer questions to maintain high satisfaction levels.
Medical Receptionist
Columbus Area Integrated Health Services Inc.
Columbus, OH
09.2014 - 05.2018
- Maintained an organized reception area and ensured that all guests were attended to promptly.
- Greeted customers warmly and made them feel welcome.
- Answered incoming calls, redirected callers to the appropriate personnel or department and took messages as needed.
- Assisted with scheduling appointments for clients and visitors.
- Managed incoming and outgoing mail, courier services, faxes and other correspondence.
- Performed data entry into computer systems to maintain accurate records of customer information.
- Provided administrative support such as filing documents, photocopying and scanning materials.
- Assisted with preparing reports, presentations and other documents as requested by management staff.
- Handled cash transactions accurately, balancing the register at the end of each shift.
- Processed payments from customers using a variety of payment methods including credit cards, checks and money orders.
- Verified identity documents for new customers before opening accounts in accordance with company policies.
- Monitored visitor access control systems including issuing identification badges when necessary.
- Tracked office supplies inventory levels, placed orders for replenishment as needed and monitored deliveries upon arrival.
- Updated customer information in databases regularly to ensure accuracy of records.
- Reconciled daily financial transactions against cash receipts at the end of each day's business activity.
- Handled payment processing and provided customers with receipts and proper bills and change.
- Welcomed patrons to front desk and engaged in friendly conversations while conducting check-in process.
- Received incoming calls and coordinated with staff to fulfill customer requests.
- Answered multi-line phone system and managed calls by routing to proper extensions or taking messages.
- Verified insurance coverage for appointments and collected co-payments as required.
- Scheduled patient appointments, verifying accuracy of appointment times with providers.
- Answered incoming calls, responding to inquiries from patients and other medical offices.
- Prepared charts for new patients, ensuring all necessary forms were completed correctly.
- Processed referrals for specialist care when requested by physicians or patients.
- Checked patients in and out for appointments and collected co-payments.
- Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
- Entered insurance, demographics and health history into patient database.
- Protected patients by observing strict HIPAA guidelines.
- Photocopied insurance cards, documented details and verified patient coverage for upcoming procedures or appointments.
- Informed patients of financial responsibilities prior to rendering services.
- Transmitted medical records and other correspondence by mail, e-mail, or fax.
- Greeted and checked in patients, updating patient information in computer system.
- Interviewed patients to complete case histories and intake forms.
Medical Records Clerk
Columbus Area Integrated Health Services Inc.
Columbus, OH
11.2008 - 09.2014
- Reviewed patient charts for accuracy and completeness.
- Entered data into electronic health record systems.
- Responded to inquiries from patients, physicians and other healthcare providers regarding medical records.
- Updated patient files with new medical information as needed.
- Performed quality assurance reviews of medical records for accuracy and completeness.
- Verified insurance eligibility prior to releasing protected health information.
- Organized patient charts, gathering medical histories, lab results and consents.
- Safeguarded patient records, managing data transfers in compliance with HIPAA standards and organizational regulations.
- Scanned and validated medical records for upload.
- Managed release of information requests and identified requestors as patient, relation or provider.
- Scanned incoming documentation.
- Tracked and processed release of information requests.
- Purged outdated files.
- Consolidated diverse medical records.
- Collected, sorted, and distributed incoming correspondence and reports related to medical records.
- Reviewed medical records for completeness and accuracy, updating information as needed.
- Accurately entered patient information into electronic health record systems.
- Updated patient demographic and insurance information in the medical record system.
- Processed and responded to external requests for medical records following established protocols.
- Compiled discharge summaries for all discharged patients.
- Maintained complete confidentiality in accordance with organization and legal requirements.
- Coordinated with healthcare providers to clarify unclear or incomplete information in records.
- Facilitated the transfer of records between departments and external healthcare facilities.
- Verified record copies before handing each over to check for and remove unnecessary details.
Secretary
Hands of Love City of Refuge
Flint, MI
08.2004 - 03.2008
- Organized and maintained executive calendars, including scheduling meetings, travel arrangements and conference calls.
- Prepared documents such as memos, letters, reports, spreadsheets and presentations using Microsoft Office applications.
- Answered incoming phone calls, responded to inquiries and transferred calls as needed.
- Maintained filing systems for confidential documents; organized files for easy retrieval of information when requested.
- Assisted with special projects or tasks related to departmental functions upon request.
- Created agendas and took minutes during meetings; distributed notes in a timely manner afterwards.
- Compiled data from various sources into clear, concise reports that could be used by management for decision-making purposes.
- Performed data entry into computer systems; ensured accuracy of all entered information.
- Proofread documents before submission; corrected any errors found in grammar or punctuation.
- Reviewed billing statements for accuracy prior to submitting them for payment processing.
- Provided assistance with onboarding new employees by preparing orientation materials.
- Answered telephone calls to give information to callers, take messages or transfer calls to appropriate individuals.
- Maintained organized filing system of paper and electronic documents.
- Coordinated communications, taking calls, responding to emails and interfacing with clients.
- Processed documents and materials for dissemination to appropriate parties.
- Anticipated leadership needs by preparing or gathering records, reports and correspondence.
- Composed and distributed reports, routine correspondence and meeting notes with job-related software.
- Operated office equipment such as photocopiers, scanners, and fax machines.
- Organized files, developed spreadsheets, faxed reports and scanned documents, maintaining front desk and reception area in neat and organized fashion.
- Created spreadsheets in Microsoft Excel for record-keeping and reporting.
- Updated system to organize office documentation, maximizing efficiency and increasing productivity.
- Managed staff calendars and coordinated travel, meeting and hotel accommodations.
Medical Records Clerk
Provider Health Net Services
Flint, MI
08.2001 - 07.2003
- Processed incoming medical records requests.
- Reviewed patient charts for accuracy and completeness.
- Maintained a secure filing system for confidential documents.
- Entered data into electronic health record systems.
- Prepared reports summarizing patient information as requested by physicians or other healthcare providers.
- Compiled discharge summaries for all discharged patients.
- Monitored compliance with state and federal regulations regarding release of information.
- Identified discrepancies between physical documentation and electronic health records.
- Conducted periodic audits of physical documentation versus electronic health records.
- Analyzed trends in utilization rates and reported findings to management.
- Resolved any discrepancies found in the review process.
- Provided training to staff members on proper documentation techniques for medical records.
- Performed quality assurance reviews of medical records for accuracy and completeness.
- Assisted in developing processes for maintaining current information in patient's files.
- Retrieved medical charts for healthcare staff for filing in medical records.
- Safeguarded patient records, managing data transfers in compliance with HIPAA standards and organizational regulations.
- Scanned and validated medical records for upload.
- Maintained complete confidentiality in accordance with organization and legal requirements.
- Managed release of information requests and identified requestors as patient, relation or provider.
- Scanned incoming documentation.
- Kept department clean, organized and professional.
- Tracked and processed release of information requests.
- Obtained information by contacting appropriate personnel or patients.
- Purged outdated files.
- Consolidated diverse medical records.
- Coordinated with healthcare providers to clarify unclear or incomplete information in records.
- Collected, sorted, and distributed incoming correspondence and reports related to medical records.
- Conducted regular training sessions for new staff on medical records management systems and procedures.
- Accurately entered patient information into electronic health record systems.
- Organized and filed hard copy patient records in designated areas.
- Reviewed medical records for completeness and accuracy, updating information as needed.
- Updated patient demographic and insurance information in the medical record system.
- Assisted in auditing medical records for compliance with legal and regulatory standards.
- Scanned and converted paper records to digital format, ensuring clear and legible documents.
- Facilitated the transfer of records between departments and external healthcare facilities.
- Indexed and cataloged medical records for easy retrieval and archival purposes.
- Generated reports on patient data and record-keeping activities as required by management.
- Monitored and managed inventory of medical record supplies, such as folders and labels.
- Implemented updates and improvements to electronic health records systems as directed.
Education
Certificate of Technical Studies - Medical Billing And Coding
Larock Health Care Academy
Columbus, Oh03-2020
Skills
- Claims Processing
- Files and records management
- HIPAA Compliance Certification
- Multitasking and Organization
- Quality-oriented team player
- Customer Service
Timeline
Medical Billing Specialist
PrimaryOne Health
07.2024 - Current
Medical Billing Specialist
Columbus Area Integrated Health Services Inc.
05.2018 - 03.2019
Medical Receptionist
Columbus Area Integrated Health Services Inc.
09.2014 - 05.2018
Medical Records Clerk
Columbus Area Integrated Health Services Inc.
11.2008 - 09.2014
Secretary
Hands of Love City of Refuge
08.2004 - 03.2008
Medical Records Clerk
Provider Health Net Services
08.2001 - 07.2003
Certificate of Technical Studies - Medical Billing And Coding
Larock Health Care Academy
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