STACY BARTON
Commerce,GA
Summary
Meticulous Medical Billing Specialist with extensive expertise in ICD-10 and CPT coding. Demonstrated success in appeals and denial management, ensuring adherence to HIPAA regulations while enhancing claims review processes.
Overview
16
16
years of professional experience
Work History
Medical Billing Specialist
Lanier Interventional Pain Center, LLC
GAINESVILLE, Georgia
09.2023 - Current
- Processed medical claims for insurance reimbursement efficiently.
- Reviewed patient accounts for accuracy and completeness.
- Communicated with insurance companies to resolve billing issues.
- Maintained patient records and updated billing information regularly.
- Coordinated with healthcare providers to ensure proper coding practices.
- Implemented billing procedures to enhance workflow efficiency.
- Assisted patients with inquiries regarding billing statements and payments.
- Stayed current on healthcare regulations affecting medical billing practices.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Adhered to HIPAA regulations when handling confidential patient information.
- Posted charges, payments and adjustments.
- 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.
- Applied payments, adjustments, and denials into medical manager system.
- Maintained detailed records of all billing activities including denials, adjustments, and payments received.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
Medical Billing Specialist
University Blood and Cancer Center
Athens, GA
05.2020 - 09.2023
- Processed medical claims for insurance reimbursement efficiently.
- Reviewed patient accounts for accuracy and completeness.
- Maintained patient records and updated billing information regularly.
- Implemented billing procedures to enhance workflow efficiency.
- Adhered to HIPAA regulations when handling confidential patient information.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
- Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Submitted refund requests for claims paid in error.
- Collaborated closely with other departments to resolve claims issues.
- Monitored aging accounts receivable balances ensuring timely resolution of outstanding balances.
- Accurately coded diagnostics and prepared billing statements for patients.
- Reviewed patient records for accuracy and completeness of information in medical billing system.
- Assisted with the reconciliation of accounts receivable ledgers at month-end close process.
- Analyzed and interpreted patient medical and surgical records to determine billable services.
- Created and processed claims to third-party payers using specific coding guidelines.
- Submitted appeals using provider portals and phone communication.
- Reviewed claims for coding accuracy.
Accounts Receivable and Billing Specialist
The Longstereet Clinic
GAINESVILLE, Georgia
09.2009 - 05.2020
- Processed medical claims using electronic billing systems and software tools.
- Reviewed and followed up on unpaid claims with insurance providers.
- Collaborated with healthcare providers to resolve billing discrepancies promptly.
- Tracked accounts receivable aging reports to identify outstanding balances.
- Tracked aging reports of unpaid claims and took corrective action when necessary.
- Analyzed medical coding issues, identified errors, made corrections, and followed up with insurance providers on denied claims as necessary.
- Reviewed patient accounts for accuracy and completeness, and submitted claims to insurance companies.
- Applied HIPAA privacy and security regulations while handling patient information.
- Completed and submitted appeals for denied claims.
- Reviewed claims for coding accuracy.
- Coordinated communications between patients, billing personnel and insurance carriers.
Education
Medical Coding And Insurance Billing
Everett Institute
Duluth, GA08-2009
Skills
- ICD-10 and CPT coding
- EPIC systems experience
- Appeals and denial management
- Detail-oriented problem solving
- Billing dispute resolution
- HIPAA compliance knowledge
- Medicare and Medicaid processes
- Quality-focused teamwork
- Claims review expertise
- Electronic claims processing
- Accounts receivable tracking
- Compliance adherence
- Attention to detail
- Problem solving
- HIPAA compliance
- Medicare and medicaid process
- Critical thinking
- Medical terminology
- Insurance billing
- Insurance claims
- Account follow-up
Timeline
Medical Billing Specialist
Lanier Interventional Pain Center, LLC
09.2023 - Current
Medical Billing Specialist
University Blood and Cancer Center
05.2020 - 09.2023
Accounts Receivable and Billing Specialist
The Longstereet Clinic
09.2009 - 05.2020
Medical Coding And Insurance Billing
Everett Institute