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Professional Summary
Senior Medical Billing Specialist who leverages strong organizational, technical and interpersonal skills. I have an extensive background in customer service and working as a team player. With six years of professional billing experience I will be an asset to help grow business.
Skills
  • Excellent Interpersonal Skills
  • Excellent Customer Service
  • Claim Entry
  • Energetic Personality
  • Online Claim Submission
  • Claims Correction
  • Superior attention to detail
  • Exceptional organization
Work History
Senior Medical Billing Specialist, 04/2017 to Current
WRS/U.S. Workers Billing Company Ann Arbor, MI
  • Successfully implemented new technologies and process automations to encourage continuous improvement.
  • Coded and entered at least 10-20 invoices each day into the in-house accounting software.
  • Composed effective accounting reports summarizing accounts payable data.
  • Posted payments to appropriate accounts.
  • Verify Worker's Compensation Benefits
  • Negotiate Price with TPA's
  • Enter Purchase Order Information into patient accounts
  • Created Training Manuel
Accounts Receivable Supervisor, 01/2016 to 04/2017
Nuvasive Clinical Services formerly Biotronic NeuroNetwork Ann Arbor, MI
  • Oversee the work and completion of my 3 team members
  • Execute submitting cases monthly effectively and efficiently
  • Review and submit time sheets
  • Transmit all claims for the Professional Billing Department Electronically
  • Field patient calls while resolving patient billing issues
  • Work front-end insurance denials
  • Manage communication to my team members
  • Process patient payments
  • Complete special projects
Lead Professional Biller, 11/2012 to 01/2016
Biotronic NeuroNetwork Ann Arbor, MI
  • Complete the highest case count of the department
  • Transmit Claims Electronically
  • Electronically Name Match Insurances
  • Field patient calls while resolving patient billing issues
  • Process patient payments
  • Complete special projects
Insurance Verification Specialist, 08/2011 to 10/2011
Biotronic NeuroNetwork Ann Arbor, MI
  • Developed the insurance verification process for Biotronic
  • Tested new software/technologies used for streamlining workflow
  • First step of developing relationship between surgeon\'s offices and Biotronic
Surgery Scheduler, 04/2009 to 08/2011
Biotronic NeuroNetwork Ann Arbor, MI

Fitness Instructor, 10/2014 to Current
PowerHouse Gym Ypsilanti Ypsilanti, MI
  • Cultivated positive relationships with participants by interacting with them during group fitness classes.
  • Promoted fitness center programs such as Les Mills RPM, Les Mills BODYPUMP and Les Mills SPRINT
  • Promote healthy life choices
  • Motivate Participants to reach goals
Education
Bachelor of Science: Women\'s and Gender Studies, 2007
Eastern Michigan University - Ypsilanti, MI 48197
This resume is created in 7 minutes.
Professional Summary

Highly skilled and effective Healthcare Professional with over 13 years in the healthcare industry. Solid billing formularies knowledge and significant experience working in hospitals, insurance and medical office environments. Skilled in managing front office functions, including customer service, patient appointments, billing and collections, and records management. Seeking a position in health administration in order to bring a proven track record of conflict resolution and customer care to a dynamic team.

 

Skills
  • Efficient medical documentation auditing for code appropriateness and guidelines
  • Skilled in preparing patients' chart, including coding and billing
  • Outstanding aptitude working in a team environment and handling responsibilities

 

  • Proficient in Microsoft Office Products, Nasco: AS400 Systems
  • Extensive knowledge of ICD-9, CPT codes, HCPCS, and pharmaceutical coding
  • Strong organizational, multi-tasking and problem solving skills
Work History
Claims Analyst, 06/2004 to Current
Horizon Blue Cross And Blue Shield Newark, NJ
  • Perform qualitative analysis of records to ensure accuracy, internal consistency and correlation of recorded data
  • Interact with providers and other medical professionals to administer timely customer service regarding billing and documentation policies, procedures and regulations in a high volume center
  • Meticulously identify and rectify inconsistencies, deficiencies and discrepancies in medical documentation with suggested resolution to appropriate departments
  • Investigate and resolve member/provider disputes of inaccurate claims information and payment by written correspondence and exceeding the company's turn around time
  • Follow adjudication policies and procedures to ensure proper payment of claims
  • Examine patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under their policies when applicable
  • Mentor and assist 15 new team members with questions and issues
Nursing Unit Coordinator, 05/2002 to 05/2012
Saint Barnabas Medical Center Livingston, NJ
  • Reviewed, analyzed, and maintained coding of diagnostic and treatment procedures contained in outpatient and inpatient medical records
  • Professionally and courteously verified patient's tests and appointment times
  • Communicated with doctors, registered nurses, patients as well as other departments to relay all needs and pharmaceutical concerns
  • Adeptly maintained medical charts and/or electronic medical records (filing, Op Reports, test results, home care forms)
  • Handled over 90 in house and outside phone calls on a daily basis from providers as well as patient's family members in regards to medical staff and ordering treatment for patients as per HIPAA guidelines
Billing Specialist, 11/1999 to 05/2002
Skytel Communications Wayne, NJ
  • Assisted customers on corporate accounts with maintenance needs such as programming issues regarding pagers on major accounts
  • Researched and resolved billing and invoicing problems
  • Sold new products and services resulting in increased revenues by 15% within the first year
  • Verified details of transactions including funds received and total account balances


Education
Associate of Applied Science: Current
Union County College - Cranford, NJ
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Professional Summary
Driven and compassionate healthcare professional with 10 years of experience in the fast-paced environments of insurance, medical billing, lab and facility. Industrious and self-motivated with a strong focus on leadership and customer satisfaction.
 
Skill Highlights
  • Staffing management ability
  • Confident public speaker
  • Complaint handling and resolution
  • Personal and professional integrity
  • Relationship and team building
  • Critical thinking proficiency
  • Healthcare billing proficiency
  • Patient/family focused
  • Acute and rehabilitative care
  • Interactive marketing
  • Public relations expert
  • Detail-oriented
  • Dedicated to process improvement 
  • Customer advocate
  • Long-term care expert
  • Self-motivated
  • Excellent communication skills
  • Extensive medical terminology knowledge
  • Proven patience and self-discipline
  • Conflict resolution
  • Deadline-driven
  • In-depth claims knowledge
  • Analytical problem solver
  • MS Office
  • MS Excel
  • Special events planning
  • Quantitative & qualitative analysis
Education and Training
High School Diploma, High School Diploma 2004 Murray High School Murray, UT, USA
Associate of Science, Healthcare Administration 2019 Salt Lake Community College Taylorsville, UT, USA Still attending
Professional Experience
Network Contractor May 2017 to Current
United Health Group West Valley, UT Contract drafting. Help broaden the Medicare Advantage network. Create and analyze data using Excel spreadsheets. Create process improvement manuals within the contracting department. 
Admissions Coordinator Jun 2015 to May 2017
Sandy Health & Rehab Sandy, UT Handle all incoming admissions in a timely and efficient manner. Serve as liaison between clinical staff and the community. Expertly plan, coordinate, organize and direct all operations of the admission. Establish and maintain positive relationships with residents, families, health care providers, physicians and the community at large. Organize and assist in leading daily personnel meetings with 15 other department heads. Work with insurance companies to obtain authorization. Evaluate patient information to determine best placement situations. Update and create monthly reports in MS excel, analyzing market and admission trends. Create marketing strategies and tools. Assist and plan marketing events.
Supervisor-Patient Advocate Jul 2012 to Jun 2015
Myriad Genetic Laboratories Salt Lake City, UT I began at Myriad as a Triage Specialist "entry level position". After two years I was promoted to a Patient Advocate and then within a year of being in this role, I was promoted to a Patient Advocate Supervisor. In this role, I launched a new platform in the customer service department. I created annual goals, objectives, and processes that were designed to create more efficiency in the department. I used quantitative and qualitative metrics to measure the effectiveness of my team. Provided thorough supervision for day-to-day operations in accordance with set policies and procedures. Regularly evaluated employee performance, provided feedback, assisted, coached and disciplined staff as needed and motivated the team in order to drive results and improve employee moral.
Self Pay Rep Level II Jan 2012 to Jun 2012
Sutter Physician Services Salt Lake City, UT Made outbound and inbound calls to patients with outstanding medical bills on behalf of Sutter Medical Foundation. Assisted in insurance claims processing to ensure timely filing. Worked with Sutter's Charity foundation to assist patients who were in need of financial assistance. 
Medical Billing Specialist Jun 2008 to Dec 2011
ABEO-Anesthesia Medical Billing Sandy, UT Handled all aspects of medical billing, including AR reports, collections and inquiries; Troubleshooting insurance claim irregularities and problems; preparing refunds, payment posting, and appeals; working with providers, insurance companies, and patients; proficient with both Medicare and Medicaid terminology.
Customer Service Representative Jan 2008 to Jun 2008
Regence Blue Cross Blue Shield Cottonwood Heights, UT Provide excellent customer experiences. Responds to inquiries regarding coverage, billing, claims or products.  Identified opportunities to cross-sell and assists with attaining agency service goals. Answer inbound and outbound calls from providers, members and other outside medical entities. Quote benefits and give claim status details. 
This resume is created in 7 minutes.
Summary
To obtain a position that will challenge my current skills and to work in an environment where my potential may grow.
Skills
  • Self-starter
  • Deadline-oriented
  • Microsoft Office
  • Employee training and development
  • Invoicing/Billing
  • Detail-oriented
  • Data Entry
  • Resourceful
  • Customer service-oriented
  • Self-starter
  • Deadline-oriented
  • Microsoft Office
  • Employee training and development
  • Invoicing/Billing
  • Detail-oriented
  • Data Entry
  • Resourceful
Experience
Billing Specialist
Century City, CA
PMK-BNC/ Feb 2017 to Current
  • Prepare and generate the monthly fee and production billing/invoices on assigned Agency clients accurately and timely, by utilizing Vantage - IPG's proprietary SAP system.
  • Analyze and generate budget reports to assure that contracts are within budget, in order to avoid Agency out of pocket costs.
  • Understand billing specifics on assigned clients to meet their agreed contract terms with the Agency.
  • Support collection efforts for assigned clients.
  • Interact with internal departments.
Sr. Biller
Burbank, CA
Coloredge Studios/ Sep 2016 to Jan 2017
  • Prepare and submit strategic and accurate client invoices on a daily basis.
  • Ensure all internal billing packets include appropriate supporting documentation.
  • Prepare and maintain detailed spreadsheets to support billing.
  • Perform monthly billing reconciliation between Navision and Virtual Ticket operating systems.
  • Balance and reconcile billing worksheets.
  • Plan and manage time to accommodate client billing deadlines.
  • Update and maintain filing, mailing and database systems.
  • Cultivate and maintain positive relationships with internal work groups and client.
Sr. Biller
Burbank, CA
Deluxe Digital Studios/ Apr 2008 to Aug 2016
  • Received billing packets from internal departments.
  • Match the purchase order with the invoice to check for correct amount and client number.
  • Process the invoices through SAP/Xytech.
  • Scan & name packets and place them in the scan folder for future reference.
  • Update Excel Spread-sheets.
  • Mail out the invoices to the client.
  • Help out other departments if necessary.
  • Complete other projects that are assigned.
  • Handle temp labor accounts for HR Handle some A/P issues that pertain to my accounts.
  • Maintain schedule to perform billing procedures in a timely manner Prepare bills and invoices base of rate cards.
  • Implement solutions to billing systems and processes.
  • Communicate with clients in person, by phone or in writing to discuss billing problems or account adjustments.
  • Act as a resource person to provide billing information to various department managers or directors within the division.
  • Verify by comparing posted information to system data.
  • Research discrepancies and recommend resolutions.
  • Train employees on various systems.
Compliance Officer
West Hills, CA
Countrywide Home Loans/MCG/ Jun 2006 to Oct 2007
  • Provide a higher and more responsive level of support for inquiries regarding: State and Federal laws and regulations Level 3 Findings High-Cost/Predatory Lending questions Manage and complete prescribed audits.
  • Review loans for compliance and enter responses in computerized database.
  • Manage to established deadlines and insure total accuracy of audits findings.
  • Assist compliance auditors with procedural policy and regulatory questions.
  • Keep VP of Compliance informed of audits progress as needed and respond to request for interim audits findings designed to identify trends and issue.
  • Perform second reviews of Compliance Auditor findings to ensure accuracy of results.
  • Make outside calls to title companies or branch employees.
  • Assist team leader with various audit tasks, including research and training.
  • Work with Microsoft Excel, AS400, and other programs.
  • Complete reports on audits and conduct detail and feedback on findings.
  • Perform specialized audits pertaining to HUD/FHA Servicing compliance testing.
  • Remove file received dates for branches and research lost/missing files.
  • Communicate with branch network to assist them in the proper resolution of on-going negative audit findings and provide direction for continued improvement.
  • Review many reports and update spread-sheets.
  • Complete special project as directed by VP of Compliance on an "as needed" basis.
  • Answer incoming phone calls from the field (branches).
  • Perform other work-related duties as assigned.
Loan Coordinator II
Chatsworth, CA
Washington Mutual/ Jun 2005 to Apr 2006
  • Received hard copy documentation as well as electronic applications.
  • Completed and documented MT and Optis duplicate searches and manually boarded hard copy loan applications Processed deposits, rate lock requests received at submission, and pre-locks.
  • Processed external requests, generated, printed, audited, and mailed disclosures to borrowers.
  • Cleared stipulations, transitioned AUS-approved loans to Approved for Validation and AUS-referred loans to Underwriting.
  • Created loan files and performed HMDA audits, as necessary.
Payoffs Technician
Simi Valley, CA
Countrywide/Venturi Staffing/ Dec 2004 to May 2005
  • Processed and delivered payoff demand statements in an accurate and timely manner.
  • Deposited all payoff funds in an error-free, expeditious manner to achieve maximum float gain for CHL.
Order Consultant Specialist
Van Nuys, CA
Moulton Logistics/ Jun 2004 to Dec 2004
  • Took inbound calls for orders.
  • Entered data into the system.
  • Handled customer faxes as well as outbound calls regarding past due payments.
E.R. Clerk
Los Angeles, CA
California Hospital Medical Center/ Jan 1998 to Jan 1999
  • My jobs duties included discharging patients through the computer, assisting doctors with patients, and organizing all patients bill and other paper work.
  • I also took incoming phone calls and helped patients to their rooms.
Education and Training
High School Diploma Sylmar High School 2002 Sylmar, CA