Summary
Skills
Work History
Education
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Shirley Clark

Medical Billing Specialist
Reisterstown,MD

Summary

Results-driven Medical Billing Professional with over 20 years of experience, known for exceptional expertise in claims processing and a steadfast dedication to delivering superior customer service. Seeking to leverage my extensive background in medical billing to contribute to a dynamic healthcare team and ensure accurate, efficient, and client-focused billing processes."

Skills

Technical Skills: Data Entry, Billing & Collection Procedures, Proficient in Microsoft Office Suites (Word, Excel, PowerPoint, Outlook etc), ICD-10, ,

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Work History

Life Insurance Agent

Self-employeed
Reisterstown, United States
04.2019 - 05.2023
  • Generated leads through cold-calling, networking, and outreach strategies.
  • Analyzed customer needs, offering tailored insurance solutions.
    Cultivated strong client relationships, ensuring high levels of customer service.
  • Developed compelling presentations and marketing materials for insurance products.
  • Provided comprehensive education on insurance policies and procedures.
  • Calculated premiums and facilitated payment methods to drive sales.
  • Conducted annual policy reviews, ensuring up-to-date information for clients.

Accounts Receivable Specialist

Nexion Health, Inc
Sykesville, MD
03.2014 - 03.2019
  • Patient Data Review: Collected and reviewed patient information, including medical records and treatment plans, ensuring accuracy for billing.
  • Insurance Verification: Verified patient demographics, insurance information, and eligibility.
  • Coding Proficiency: Assigned appropriate medical codes (ICD-10, CPT, HCPCS) to diagnoses and procedures for billing purposes.
  • Claims Submission: Created and submitted insurance claims electronically or via paper forms (UB-04, 1500) to relevant payers, including private insurance companies, Medicare, and Medicaid.
  • Claim Monitoring: Continuously monitored claim status and proactively followed up on denials or rejections.
  • Claim Corrections: Made necessary corrections and resubmitted claims when required, ensuring timely reimbursement.
  • Patient Support: Addressed patient inquiries related to billing and assisted in arranging payment arrangements.
  • Payment Recording: Accurately recorded and posted payments received from insurance companies and patients into the billing software system.

Corporation Facility Collector

MobileX USA
Sparks, MD
02.2013 - 03.2014
  • Proactive Communication: Initiated contact with clients, customers, or vendors with overdue accounts to remind them of outstanding balances.
  • Multichannel Negotiation: Utilized various communication channels (phone, email, letters) to negotiate payment arrangements and prompt payment.
  • Negotiation Expertise: Negotiated payment plans and settlements with debtors based on company policies and individual financial circumstances.
  • Account Reconciliation: Reviewed accounts receivable records to identify discrepancies, errors, or payment irregularities.
  • Accurate Documentation: Ensured accurate and legally sound documentation of all agreements reached during the collection process.
  • Payment Monitoring: Monitored payment schedules and diligently followed up on missed or delayed payments.
  • Payment Allocation: Recorded payments received from debtors, updated account records, and allocated payments to the appropriate invoices.
  • Comprehensive Record-keeping: Maintained accurate and organized records of communication, payment arrangements, and collection efforts.
  • Clear Communication: Provided clear explanations of outstanding balances, payment terms, and potential consequences of non-payment.
  • Performance Reporting: Generated reports on collection activities, payment trends, and outstanding balances for management review.

AR/Medical Billing Specialist

Nexion Health, Inc
Sykesville, MD
06.2011 - 12.2012
  • Prepared and electronically submitted claims to insurance companies, Medicare, Medicaid, and other relevant third-party payers. Ensured inclusion of all necessary documentation and coding to support each claim.
  • Translated medical procedures, diagnoses, and treatments into standardized codes (CPT, ICD-10, HCPCS) to accurately represent services provided for billing and insurance purposes.
  • Verified patients' insurance coverage, policy details, and eligibility prior to initiating billing procedures.
  • Verified patients' insurance coverage, policy details, and eligibility prior to initiating billing procedures.
  • Monitored claim status, identifying rejections or denials, and took prompt actions to rectify errors, resubmit claims, or appeal denials for maximum reimbursement.
  • Successfully obtained Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERA) from clearing houses and online portals in a timely manner.
  • Facilitated clear communication between patients, insurance companies, and the billing office, serving as a liaison to ensure smooth interactions.
  • Recorded and reconciled payments received from insurance companies, patients, and other sources against billed amounts. Identified discrepancies and proactively addressed underpayments or overpayments.
  • Responsively addressed patient inquiries regarding billing, insurance coverage, and payment options. Provided clear explanations of billing statements and expertly assisted in resolving disputes or concerns.

Senior Office Manager

Rural Health Group, Inc
Roanoke Rapids, NC
06.2008 - 04.2010
  • Supervised and coordinated administrative staff, assigning tasks and responsibilities as needed.
  • Maintained an organized, professional, and productive office environment.
  • Managed office supplies, equipment, and facility maintenance for optimal functionality.
  • Served as the primary point of contact for internal and external communications, including emails, phone calls, and inquiries.
  • Assisted in recruitment, selection, and onboarding of new employees.
  • Maintained comprehensive employee records, including attendance, leave, and performance evaluations.
  • Addressed employee concerns, conflicts, and fostered a positive work environment.
  • Collaborated with finance teams to oversee invoices, accounts payable, and receivables.
  • Coordinated schedules, appointments, and meetings to optimize time and resources.
  • Generated reports, presentations, and documents for internal and external stakeholders.
  • Enforced company policies and procedures to ensure compliance and consistency.
  • Ensured strict adherence to health and safety regulations, including emergency protocols and workplace security.
  • Addressed client or customer inquiries, feedback, and concerns in a professional and prompt manner.

Education

Master of Science - Business

Strayer University
Washington DC
10.2019 - 12.2020

Bachelor of Science - Healthcare Administration

Strayer University
Washington DC
04.2015 - 12.2017

Associate of Applied Science degree - Applied Science

Halifax Community College
04.2001 - 05.2003

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Shirley ClarkMedical Billing Specialist