Tara Butler
Aurora,CO
Summary
Experienced Medical Billing Manager skilled in optimizing billing processes and enhancing revenue cycle efficiency. Adept at leading teams, solving problems, and ensuring compliance in healthcare settings. Proven ability to train staff on medical coding, claims processing, and billing procedures. Demonstrated success as a liaison between medical professionals and insurance companies.
Overview
15
15
years of professional experience
Work History
Medical Billing and Denial Specialist
Advanced Pain and Anesthesia
Englewood, CO
03.2011 - 04.2025
- Entry of all charges, payment posting, adjustments, pursues collection of all claims until payment is made by insurance company and patient
- Prepare and submits claims to third-party insurance carriers either electronically or by hard copy billing.
- Secure needed medical documentation required or requested by third party insurances.
- Follow up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains.
- Process all denials and file all appeals.
- Process rejections by either making accounts private and generating a notice of rejection to patient or correcting any billing error and resubmitting claims to third-party insurance carriers.
- Work with client to ensure that correct diagnosis/procedures are reported to third party insurance carriers.
- Keeps updated on all billing and benefit changes for third-party insurance carriers.
- Posts third-party insurance remittance advices.
- Keeps updated on all third-party billing requirements and changes for insurance types within the area of responsibility.
- Evaluates and presents insurance billing requirement changes to department, as well as client as necessary.
- Works with doctors/or management on special projects as assigned.
- Demonstrates knowledge of and supports billing office mission, vision, value statements, standards, policies, and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.
Medical Biller, Accounts Receivable
Rocky Mountain Gastroenterology
Lakewood, CO
11.2009 - 01.2011
- Entry of all charges, payment posting, adjustments, pursues collection of all claims until payment is made by insurance company and patient
- Prepare and submits claims to third-party insurance carriers either electronically or by hard copy billing.
- Follow up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains.
- Posts third-party insurance remittance advices.
- Process all claim denials and file appeals.
Education
High School Diploma -
Highland High School
Palmdale, CA06-1998
Skills
- Medical Coding: Proficient in assigning accurate codes using ICD-10, CPT, and HCPCS coding systems
- Claims Processing: Knowledgeable in processing insurance claims, including verifying patient information, submitting claims, and handling claim denials
- Reimbursement Expertise: Familiarity with different reimbursement methodologies and an understanding of insurance policies and guidelines
- Medical Terminology: Solid understanding of medical terminology and anatomy to ensure accurate coding and documentation
- Communication: Effective communication skills to liaise with healthcare providers, insurance companies, and patients regarding billing matters
- Billing and Reimbursement Regulations: In-depth knowledge of billing and reimbursement regulations, including Medicare, Medicaid, and third-party
Timeline
Medical Billing and Denial Specialist
Advanced Pain and Anesthesia
03.2011 - 04.2025
Medical Biller, Accounts Receivable
Rocky Mountain Gastroenterology
11.2009 - 01.2011
High School Diploma -
Highland High School
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