Organized Medical Biller thoroughly versed in medical coding and HIPAA requirements. Personable professional with several 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
12
12
years of professional experience
Work History
Follow up (Contract Ends Mid November 2024)
Health-Tech (Remote)
04.2024 - Current
Handled patient and other correspondences, including detailed reports to meet organizational expectations
Conducted research on overdue billing by contacting patients, local affiliates and insurance carriers
Advised finance staff and providers regarding changes to procedural and billing codes from Medicare, Medicaid and private insurance carriers
Resolved accounts quickly and accurately to obtain maximum reimbursement
Verified coverage with insurers, filed required forms and submitted paperwork to obtain timely payments
Medical Billing Level 2 Team Lead
Trinity Health (Remote)
Gainesville
11.2022 - 04.2024
Started with a Temp agency (GHR) and I was on assignment with Trinity Healthcare and the temp assignment last 6 months then I was hired on fulltime with Trinity health
HB and PB billing In Epic, I Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules
Precisely completed appropriate paperwork and system entry regarding claims
Identified errors and re-filed denied or rejected claims quickly to prevent payment delays
Contacted insurance providers to verify insurance information and obtain billing authorization
Posted charges, payments and adjustments
MEDICARE MEDICAL BILLER
Haven Hospice (Hybrid)
Gainesville, USA
11.2021 - 11.2022
Completed and submitted appeals for denied claims
Coordinated communications between patients, billing personnel and insurance carriers
Posted charges, payments and adjustments
Identified errors and re-filed denied or rejected claims quickly to prevent payment delays
Posted and adjusted payments from insurance companies
Reviewed and verified benefits and eligibility with speed and precision
Collaborated closely with other departments to resolve claims issues
Entered procedure codes, diagnosis codes and patient information into Ability, MyUnity, DDE
Contacted insurance providers to verify insurance information and obtain billing authorization
Precisely completed appropriate paperwork and system entry regarding claims
Medical Billing Manager
Gainesville Prosthetics (Hybrid)
Gainesville, USA
01.2021 - 07.2021
Verify CPTs were correct before billing
Apply payments
Monitor and train front desk
Office Duties
The Owner was talking about going all self pay since it was a small 2 provider DME clinic and I left the job due to my father had colon cancer and I took time to help him and my mother for 5 months
He is 100% now and doing great
Financial Counselor
Florida Cancer Specialists
08.2020 - 01.2021
Responsible for monitoring and collecting the financial responsibilities of our patients
The Financial Counselor Float must keep patients' insurance benefits up to date in Onco EMR and Centricity and view the patients' services for diagnosis and insurance coverage appropriateness
Also performs the daily tasks of Managed Care and Financial Counselor
This position must travel to any office/clinic within their 'region' and when not covering for another Financial Counselor as the float will be assigned various Financial Counselor work to assist others
Obtain Authorizations from the patient's insurance company
MEDICAL BILLING SPECIALIST
The Cardiac and Vascular Institute
Ocala
10.2018 - 08.2020
Work HB and PB as well as Acute Hospital A/R and collections
Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes
Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house
Posted and adjusted payments from insurance companies
Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements
Performed full-cycle medical billing in a fast-paced medical billing company
Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies
Reviewed and verified benefits and eligibility with speed and precision
Completed appeals and filed and submitted claims
Submitted refund requests for claims paid in error
Identified errors and re-filed denied or rejected claims in a timely manner
Kept detailed and accurate documentation of payments, charges and write-ups of cardiovascular procedures
Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials
BILLING SPECIALIST
CITRUS CARDIOLOGY
03.2018 - 10.2018
Collect all the information necessary to prepare insurance claims and bill patients
Enter patient demographic and insurance information into the medical claim software
Enter patient encounter information
Review accounts for possible assignments and prepares information for the collections agency
Fill in the claim form accurately by contacting the patients, company, or the health institution, for a single mistake might delay the whole process
CARE TEAM COORDINATOR
Kindred at Home
09.2017 - 03.2018
Developed and implemented strategies to ensure all care team members had the necessary resources to accomplish their duties.
Provided guidance on complex clinical issues and assisted in resolving conflicts between team members.
Maintained accurate records of case reviews and follow-up actions taken by the care team.
4 Different Departments
University of Florida Health
Jacksonville, USA
06.2012 - 09.2017
UF Jacksonville Physicians:
Batcher:
Maintained accurate records of all batches produced, including batch numbers and quantities.
Assisted in the development of new processes and procedures for batching operations.
UF Health Shands Gaineville:
H.I.M tech:
Reviewed medical records for completeness, accuracy and compliance with regulatory standards.
Maintained patient confidentiality in accordance with HIPAA regulations.
Assisted in the preparation of documents for filing and scanning into electronic health record systems.
Verification specialist:
Reviewed medical records to ensure accuracy of required information needed for pre-authorization requests.
Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system.
Eye clinic check out:
Developed and maintained scheduling procedures to ensure timely completion of projects.