Category: HEALTHCARE

         HOSPITAL & PHYSICIAN BILLING SPECIALIST           Professional Summary     HIGHLY-ORGANIZED PROFESSIONAL WHO EXCELS AT ASSISTING HEALTHCARE PROVIDERS WITH BILLING MANAGEMENT & CODING SUPPORT. WELL-ROUNDED TEAM PLAYER WITH A STRONG TRACK RECORD OF WORKING IN COLLABORATIVE ENVIRONMENTS, AND DRIVING BOTTOM LINE GROWTH THROUGH REDUCING OUTSTANDING RECEIVABLES. EXCELLENT COMMUNICATOR AND FREELANCE HEALTHCARE MARKETING CONSULTANT WHO EXCELS AT ESTABLISHING A RAPPORT WITH CLIENTS FROM DIVERSE BACKGROUNDS. PROBLEM SOLVER WHO EXERCISES CRITICAL THINKING, AND PERFORMS WORK AHEAD OF SCHEDULE. SEEKS TO TRANSITION INTO A MANAGEMENT ROLE WITH A PHYSICIAN'S OFFICE THAT WILL UTILIZE THE TALENTS/SKILLS OF AN EXPERIENCED MEDICAL BILLING SPECIALIST, AND ASPIRING OFFICE MANAGER.       Licenses          Skill Highlights          Collections & Receivables  Patient Advocacy   ICD-9 & ICD-10 Standards  Medical Billing & Coding   Administrative Support   Electronic Medical Records   Insurance Verification   Marketing & Design   HIPPA Compliance   FACS  Athena  Centricity  Medical Manager  MediTech  MediSoft  TruCode  NueMD   Microsoft Office Suite (Word, Excel, Access, Outlook, PowerPoint) ● QuickBooks    Knowledge of HMOs, Medicare and Medi-Cal  Medical Manager Software  Managed care contract knowledge  Electronic Medical Record (EMR) software  ICD-9 coding  Trained in ASC Coding  CPT and HCPCS coding  Internal medicine billing  HHM and Medisoft billing systems  HIPAA compliance  Medical billing software  Strong planning skills  Technical expertise  Patient-focused care  Strong work ethic  Team player with positive attitude  Deadline-driven  Good written communication  Exercises good judgment              Professional Experience      Hospital & Physician Billing Specialist    December 2013   to   Current     Company Name   －   City  ,   State      Responsible for managing and resolving insurance denials for medical, Workers Compensation and Personal Injury claims. Works with a team of Billing Specialists to interact with major insurance carriers, as well as government payers, including Medicare. Accountable for ensuring all new insurance claims are filed in a timely manner to prevent future reimbursement issues.   Key Achievements & Bottom Line Growth  Reduced receivables for a major North Carolina medical center from $4M to $520K in an 8-month period by reversing denials for patients via the insurance firms' appeal process, and by providing documentation confirming procedures were necessary  Created and implemented new processes to facilitate the timely filing of new insurance claims          Healthcare Marketing Consultant / Freelancer    January 2009   to   Current     Company Name   －   City  ,   State     Provides ongoing marketing support to Scripps Memorial Hospital and Scripps Mercy Hospital in San Diego. Assists with projects including graphic design, marketing materials, industry trade shows, and implementing marketing to promote fundraising events.         Physician Billing Specialist    March 2012   to   January 2013     Company Name   －   City  ,   State      Served in a frontline role, and was tasked with managing 40 accounts on a daily basis as well as assisting with medical billing and collections software. Provided daily updates to physicians' office managers on the Athena billing software packages via teleconference.   Key Achievements & Bottom Line Growth  Slashed accounts receivables for 40 Florida-based member physician offices from $6M to $2M in a 10-month period  Consulted with senior management to expand Unified Physician Management's membership operations into the Northeast region, adding 52 new practices in a 7 month period, and increasing reimbursement rates via group membership          Hospital and Physician Billing Specialist    June 2009   to   May 2010     Company Name   －   City  ,   State     Joined as an Insurance Verifier and was quickly promoted to a Billing Specialist. Responsible for auditing patient accounts for production of clean claims, which resulted in 15% fewer rejected claims, and reimbursement received from the carriers within an average of 45 days or less.            Education and Training      Bachelor of Science   :   Business Management      Canisius College   －   City  ,   State  ,   US    Bachelor of Science in Business Management with a Marketing Minor, Canisius College | Buffalo, NY        Associate of Science   :   Medical Billing and Coding      San Diego City College   －   City  ,   State  ,   US    Associate of Science in Medical Billing and Coding, San Diego City College | San Diego, CA        Accomplishments           Skills     Marketing, Fundraising, Graphic Design, Healthcare, Billing, Claims, Receivables, Accountable For, Auto Insurance, Compensation, Documentation, Filing, Insurance Claims, Medicare, Workers Compensation, Medical Billing, Medical Invoicing, Accounts For, Auditing, Accounts Receivables, Basis, Collections, Credit, Operations, Access, Administrative Support, Excel, Hippa, Icd, Icd-9, Medical Billing & Coding, Medical Records, Medisoft, Meditech, Microsoft Office, Ms Office, Outlook, Powerpoint, Quickbooks, Word, Associate, Business Management, Coding