Seeking a career in Medical Insurance; Medical Billing & Coding; Hospital Billing ;Insurance; Eager to utilize my skills and experience for the benefit and growth of your company's business.
Overview
25
25
years of professional experience
Work History
Revenue Cycle Specialist
Signature Performance Inc
08.2022 - Current
I am responsible for billing follow/up on institutional and professional hospital claims, Performs complex clerical and accounting functions for patient billing, including verification of invoice information, maintenance of third party billing records, and resolution of problems
Follows up on submitted claims and patient billing; resubmits claims or correct inaccuracies, medical records, corrected claims, appeals/reconsiderations, customer service
Medical Billing Specialist
Carolinas Dermatology And Plastic Surgery LLC
Columbia, SC
09.2021 - Current
I am responsible for properly coding all medical services, procedures, diagnoses, and treatments
Preparing and sending invoices or claims for payment
Performs complex clerical and accounting functions for patient billing, including verification of invoice information, maintenance of third party billing records, and resolution of problems
Follows up on submitted claims and patient billing; resubmits claims or correct inaccuracies
Claim entry payment posting, manage medical billing for patients, updating patient information, generating invoices, and processing payments
Provider Enrollment Analyst
PALMETTO GBA
Columbia, SC
03.2017 - 09.2021
I was responsible for reviewing, approving, denying, and processing all applications submitted by providers who want to provide medical services covered under Medicare Insurance Plans
I work within appropriate standards and timelines established by the Centers for Medicare and Medicaid Services (CMS) Medicaid CSA
Provider Service Advocate II
KELLY SERVICES
08.2016 - 03.2017
I was responsible for responding to provider service and customer service inquiries; verify insurance coverage/benefits; process corrected claims; review and adjudicate customer and provider appeals; refund requests; special projects; faxing, indexing & scanning etc
Claims Provider Service Advocate II
BCBS/ FEP
08.2012 - 05.2016
I was responsible for responding to provider service and customer service inquiries; verify insurance coverage/benefits; process corrected claims; review and adjudicate customer and provider appeals; refund requests; special projects; faxing, indexing & scanning etc
Technical Information Specialist
KELLY SERVICES
10.2011 - 05.2012
I was responsible for processing claims for Medicare Part B, signature attestation statements, mac adjudications, prescreening, second screen work, special projects, etc
Patient Service Representative
DOCTORS CARE WATEREE
03.2008 - 02.2010
I was responsible for the check in/check out of patients, insurance follow-up, ICD-9CM, CPT, HCPCS coding on patient encounters, scheduling appointments, customer service, cashier, collecting co-pays & payments, posting payments to accounts, verifying insurance coverage/benefits, proofing/ posting of cash drawer, reports, chart filing, medical records, scanning, faxing & etc
Patient Account Representative II
Patient Financial Services
09.2008 - 01.2010
I was responsible for collecting payments, billing claims, insurance follow-up, verifying insurance coverage, cashier, proofing/posting of cash drawer, customer service, financial assistance, processing refunds, journal entries for daily batch cash sheets, adjustments/appeals, medical records, scanning, payment plans, special projects, reports, faxing & etc
Managed Care Support Tech I / Call Center Representative
BCBS
05.2004 - 03.2008
I was responsible for processing & paying all types of workers compensation claims, (medical, dental, pharmacy, transportation, DME), customer service ACD line, processing first reports of injury and/or insurance claims for automobile, umbrella, property, & condo insurance, bill/check status, adjustments/appeals, processing refunds, reports, special projects, scanning, faxing & etc
Patient Representative I
KERSHAW COUNTY MEDICAL CENTER
01.2000 - 08.2004
I was responsible for operating the main switchboard, scheduling appointments for all patient types, registering/pre-registering patients, transferring/discharging/admitting patients, verifying insurance coverage, collecting payments, medical records, reports, scanning, faxing & etc
Managed Care Support Tech I / Call Center Representative
BCBS
12.2001 - 12.2003
I was responsible for processing & paying all types of workers compensation claims, (medical, dental, pharmacy, transportation, DME), customer service ACD line, processing first reports of injury and/or insurance claims for automobile, umbrella, property, & condo insurance, bill/check status, adjustments/appeals, processing refunds, reports, special projects, scanning, faxing & etc
Education
Certification - Medical Billing & Coding
Centura College-Columbia
Columbia, SC
12.2011
Diploma -
North Central High School
06.1998
Skills
Epic
Cerner
EDI
ICD-10
Medical billing
CPT coding
Medical coding
Revenue cycle management
Medical records
Medical terminology
ICD coding
EMR systems
Workers' compensation law
Microsoft Access
Clerical experience
Customer service
Hospital experience
Analysis skills
Cash handling
Cash register
Microsoft Office
ICD-9
Microsoft Word
Medical office experience
Anatomy knowledge
Typing
Time management
Office experience
Organizational skills
Claims review
Timeline
Revenue Cycle Specialist
Signature Performance Inc
08.2022 - Current
Medical Billing Specialist
Carolinas Dermatology And Plastic Surgery LLC
09.2021 - Current
Provider Enrollment Analyst
PALMETTO GBA
03.2017 - 09.2021
Provider Service Advocate II
KELLY SERVICES
08.2016 - 03.2017
Claims Provider Service Advocate II
BCBS/ FEP
08.2012 - 05.2016
Technical Information Specialist
KELLY SERVICES
10.2011 - 05.2012
Patient Account Representative II
Patient Financial Services
09.2008 - 01.2010
Patient Service Representative
DOCTORS CARE WATEREE
03.2008 - 02.2010
Managed Care Support Tech I / Call Center Representative
BCBS
05.2004 - 03.2008
Managed Care Support Tech I / Call Center Representative
Revenue Cycle Specialist at Chicago Center For Sports Medicine And Orthopedic SurgeryRevenue Cycle Specialist at Chicago Center For Sports Medicine And Orthopedic Surgery