Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Siobhan Taylor

Phoenix,AZ

Summary

Confident Medical Biller with 5+ years experience, and knowledge with ICD-9, ICD-10, HCPC's and CPT coding, and HCFA 1500, UB-04, CMS,and Pharmacy claim forms.

Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors.

Overview

7
7
years of professional experience
1
1
Certification

Work History

Medical Biller

CVS Healthcare
Phoenix , ARIZONA
05.2017 - 10.2022
  • Epic Medical Infusion Biller that reviewed patient records, identified medical codes and created invoices for billing purposes for Commercial, Medicaid, Medicare, and TRICARE Insurances.
  • Delivered timely and accurate charge submissions.
  • Reviewed patient diagnosis codes to verify accuracy and completeness on HCFA 1500 and UB-04 claims.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Liaised between patients, insurance companies and billing office.
  • Gathered information from multiple sources and medical programs, ie: HC 360,CMD, e'Premis, MediAR, Provider Payor Portals, ECM, and ERN to simplify billing and organize accounts.
  • Orchestrated medical coding, payment posting, accounts receivables and collections.
  • Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
  • Communicated with insurance providers to resolve denied claims and resubmitted
  • Reviewed patient records, identified medical codes and created invoices for billing purposes

Prior Authorization Specialist

Superior Vision
Phoenix, Arizona
10.2015 - 11.2016
  • Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
  • Verified eligibility and compliance with authorization requirements for service providers.
  • Fielded telephone inquiries on authorization details from plan members and medical staff.
  • Created and maintained spreadsheets detailing Prior Authorizations procedures, and denials and approvals.
  • Authorized surgical and requests in accordance with Medicaid guidelines.
  • Communicated with patients and Medical Staff from various cultures and backgrounds on Prior Authorizations Approval requirements and process.
  • Followed guidelines when reviewing applicant data to determine eligibility for Medicaid Health First Insurance.

Education

Associate of Science - HealthCare Administration

Ashford University
Clinton, IA
10.2010

No Degree - Medical Assisting Certification

Lamson College
Tempe, AZ
05.2007

Associate of Arts - Communication

Maricopa Community Colleges - South Mountain Community College
Phoenix, AZ
05.2007

Skills

  • Claim Processing
  • Diagnostic Codes, ICD-10/9 Codes
  • Insurance Claim Requirements
  • Reviewing Patient Information
  • CMS-1500, HCFA 1500 Billing Forms
  • Proficient with Excel, WORD, Teams, and Outlook
  • HIPAA Compliance Certification
  • SMS
  • Commercial and Private Insurance, Medicaid, Medicare, and TRICARE
  • Billing and Collections Procedures
  • Medical Terminology
  • Records Management, and Spread Sheet Tracking
  • Medicare and Medicaid Knowledge

Certification

Medical Assisting Certification

Phlebotomy Certification

Timeline

Medical Biller

CVS Healthcare
05.2017 - 10.2022

Prior Authorization Specialist

Superior Vision
10.2015 - 11.2016

Associate of Science - HealthCare Administration

Ashford University

No Degree - Medical Assisting Certification

Lamson College

Associate of Arts - Communication

Maricopa Community Colleges - South Mountain Community College

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Siobhan Taylor