Summary
Overview
Work History
Education
Skills
Timeline
Generic

Tessa Peters, CPC

Bardstown,KY

Summary

Efficient Medical Billing Coder with 23 years of experience in handling wide variety of medical coding and billing tasks. Productive and diligent with passion for resolving discrepancies through attention to detail and creative problem-solving. Passionate about perpetuating company values through impeccable work ethic and drive.

Overview

23
23
years of professional experience

Work History

Medical Billing Specialist

Confluent Healthcare
12.2021 - Current
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Located errors and promptly refiled rejected claims.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Identified and resolved patient billing and payment issues.
  • Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
  • Posted and adjusted payments from insurance companies.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Precisely evaluated and verified benefits and eligibility.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Filed and updated patient information and medical records.
  • Prepared billing correspondence and maintained database to organize billing information.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Liaised between patients, insurance companies, and billing office.
  • Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
  • Printed and reviewed monthly patient aging report and solicited overdue payments.
  • Evaluated patients' financial status and established appropriate payment plans.
  • Responded to customer concerns and questions on daily basis.
  • Audited and corrected billing and posting documents for accuracy.

Medical Billing Specialist

Dunn Physical Therapy
10.2012 - 12.2021
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Located errors and promptly refiled rejected claims.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Identified and resolved patient billing and payment issues.
  • Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
  • Collected payments and applied to patient accounts.
  • Posted and adjusted payments from insurance companies.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Precisely evaluated and verified benefits and eligibility.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Filed and updated patient information and medical records.
  • Prepared billing correspondence and maintained database to organize billing information.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Liaised between patients, insurance companies, and billing office.
  • Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
  • Printed and reviewed monthly patient aging report and solicited overdue payments.
  • Evaluated patients' financial status and established appropriate payment plans.
  • Maintained and updated collections tracking spreadsheet to help organize payment information.
  • Managed collections claims for unpaid bills against estates of debtors.
  • Pre-certified medical and radiology procedures, surgeries and echocardiograms.
  • 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 diagnosis codes to verify accuracy and completeness.
  • Reviewed patient records, identified medical codes, and created invoices for billing purposes.
  • Prepared billing statements for patients and verified correct diagnostic coding.
  • Delivered timely and accurate charge submissions.
  • Adhered to established standards to safeguard patients' health information.
  • Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
  • Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
  • Used data entry skills to accurately document and input statements.
  • Responded to customer concerns and questions on daily basis.
  • Audited and corrected billing and posting documents for accuracy.
  • Handled account payments and provided information regarding outstanding balances.
  • Monitored outstanding invoices and performed collections duties.
  • Collaborated with customers to resolve disputes.
  • Maintained accurate records of customer payments.
  • Utilized various software programs to process customer payments.
  • Processed payment via telephone and in person with focus on accuracy and efficiency.
  • Generated monthly billing and posting reports for management review.
  • Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
  • Entered invoices requiring payment and disbursed amounts via check, electronic transfer or bank draft.
  • Kept vendor files accurate and up-to-date to expedite payment processing.
  • Reconciled accounts receivable to general ledger.
  • Generated accounts payable reports for management review to aid in financial and business decision making.
  • Created improved filing system to maintain secure client data.
  • Processed vendor and supplier payments on weekly basis.
  • Disbursed petty cash by recording entries and verifying documentation.
  • Encoded and canceled checks using bank machines.
  • Credentialing Applications/Processing


Medical Billing Specialist

Professional Data Control
04.2000 - 08.2008
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Located errors and promptly refiled rejected claims.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Identified and resolved patient billing and payment issues.
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
  • Posted and adjusted payments from insurance companies.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Prepared billing correspondence and maintained database to organize billing information.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Liaised between patients, insurance companies, and billing office.
  • Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
  • Printed and reviewed monthly patient aging report and solicited overdue payments.
  • Maintained and updated collections tracking spreadsheet to help organize payment information.
  • Evaluated patients' financial status and established appropriate payment plans.
  • Managed collections claims for unpaid bills against estates of debtors.
  • 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 diagnosis codes to verify accuracy and completeness.
  • Reviewed patient records, identified medical codes, and created invoices for billing purposes.
  • Prepared billing statements for patients and verified correct diagnostic coding.
  • Delivered timely and accurate charge submissions.
  • Adhered to established standards to safeguard patients' health information.
  • Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
  • Used data entry skills to accurately document and input statements.
  • Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
  • Responded to customer concerns and questions on daily basis.
  • Audited and corrected billing and posting documents for accuracy.
  • Monitored outstanding invoices and performed collections duties.
  • Handled account payments and provided information regarding outstanding balances.
  • Collaborated with customers to resolve disputes.


Education

High School Diploma -

Pleasure Ridge Park High School
Louisville, KY
05.1998

Skills

  • Critical Thinking
  • Customer Service
  • Time Management
  • Data Entry
  • Physician Interaction
  • Diagnostic Codes
  • File and Records Management
  • Medicare and Medicaid Processes
  • Reviewing Patient Information
  • Collection Calls
  • Bill Payment
  • Strategic Initiatives
  • Billing Codes
  • CPT Code Modifiers
  • Active Listening
  • Account Management
  • ICD-10 Coding
  • Work Prioritization
  • Medical Claims Submission
  • Adjustment Posting
  • Medical Billing
  • Statement Billings
  • HIPAA Compliance
  • Insurance Collections
  • CMS-1500 Billing Forms
  • Insurance Claim Requirements
  • Regulatory Compliance
  • Insurance Authorizations
  • Benefits Verifications
  • Medical Coding Knowledge
  • Workers' Compensation Knowledge
  • Claim Verifications
  • A/P and A/R Expertise
  • Prepare Statements
  • Work Coordination

Timeline

Medical Billing Specialist

Confluent Healthcare
12.2021 - Current

Medical Billing Specialist

Dunn Physical Therapy
10.2012 - 12.2021

Medical Billing Specialist

Professional Data Control
04.2000 - 08.2008

High School Diploma -

Pleasure Ridge Park High School

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Tessa Peters, CPC