TERESA HILES
Maysville,Kentucky
Summary
Medical billing specialist with proven experience in managing complex billing processes and reducing errors. Strong focus on team collaboration and achieving results, adaptable to changing environments. Skilled in coding, claims processing, and compliance with healthcare regulations. Reliable and efficient, known for handling sensitive information with confidentiality and precision.
Overview
30
30
years of professional experience
Work History
Medical Billing Coordinator
Main Street Primary Care & Aesthetics Formerly Family Practice Associates
09.2004 - Current
- Leveraged strong organizational skills to maintain comprehensive patient accounts, enabling quick access to relevant information during billing inquiries.
- Reduced claim denials and rejections by conducting thorough audits and addressing discrepancies prior to submission.
- Maintained detailed knowledge of various payer requirements, facilitating smoother interactions between healthcare providers and insurance companies during claims processing efforts.
- Ensured compliance with industry regulations by staying current on changes in medical coding guidelines and maintaining accurate records.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Collected payments and applied to patient accounts.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Located errors and promptly refiled rejected claims.
- Identified and resolved patient billing and payment issues.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
- Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Precisely evaluated and verified benefits and eligibility.
- Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
- Filed and updated patient information and medical records.
- Coordinated with other departments to address any discrepancies or concerns related to charge capture or data entry accuracy.
- Liaised between patients, insurance companies, and billing office.
- Streamlined billing processes by implementing efficient workflows and utilizing advanced software tools.
- Efficiently processed refunds or adjustments for patients when necessary, ensuring accuracy and compliance with company policies.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Reduced errors in medical billing by meticulously reviewing patient records and ensuring accurate coding.
- Verified insurance of patients to determine eligibility.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Posted payments and collections on regular basis.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Collaborated closely with the clinical team to ensure proper documentation was obtained for accurate billing purposes.
- Delivered timely and accurate charge submissions.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Responded to customer concerns and questions on daily basis.
- Used data entry skills to accurately document and input statements.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Audited and corrected billing and posting documents for accuracy.
- Maintained accurate records of customer payments.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Generated monthly billing and posting reports for management review.
- Handled account payments and provided information regarding outstanding balances.
Office Manager /Medical Billing Specialist
Mason County Chiropractic
03.1999 - 09.2004
- Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
- Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
- Maintained accurate financial records by reconciling accounts payable/receivable transactions regularly to ensure balanced budgets.
- Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
Medical Billing Coordinator
Maysville Obstetrics & Gynecology
08.1995 - 04.1999
- Developed a comprehensive understanding of medical terminology and coding systems to accurately translate services provided into billable charges on patient accounts.
- Enhanced patient satisfaction with clear communication of payment expectations, resolving concerns, and providing flexible payment options.
- Contributed to the development of best practices for medical billing operations, ensuring consistency across all departments within the organization.
- Prepared billing correspondence and maintained database to organize billing information.
- Contributed to overall office organization by maintaining up-to-date records of all billed services and payments received.
- Prepared billing statements for patients and verified correct diagnostic coding.
Education
Maysville High School
Maysville, KY05-1982
Skills
- ICD-10 knowledge
- Organizational growth
- Claims processing proficiency
- Motivation and initiative
- CPT coding
- Payment posting
- Accounts receivable management
- Electronic health records management
- Teamwork and collaboration
- Customer service
- Billing and collection procedures
- Work prioritization
- Problem-solving
- Time management
- Attention to detail
- Multitasking
- Account reconciliation
- Verbal and written communication
Timeline
Medical Billing Coordinator
Main Street Primary Care & Aesthetics Formerly Family Practice Associates
09.2004 - Current
Office Manager /Medical Billing Specialist
Mason County Chiropractic
03.1999 - 09.2004
Medical Billing Coordinator
Maysville Obstetrics & Gynecology
08.1995 - 04.1999
Maysville High School
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