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AmerisourceBergen - Billing Specialist Resume Example

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Joseph Clark
XXXX XXXXX XXXX, Charlotte, NC 28212
XXXXXXXXXXXXXXXXXXXXXXXXXXX
Ph: XXXXXXXXXXXX
Professional Summary

Self motivated Medical Billing and Coding specialist with extensive training and related education. Seeking an
organization offering a challenging environment with the opportunity to apply existing skills and develop new ones.
Skills
  • Knowledge and use of Epic/Emdeon & WorkQue
  • ICD9 & 10 (Procedure coding)
  • CMS1500 UB-04 Billing Claims
  • Deciphering/explaining EOB'S Aging Reports, Remittance Advice Microsoft Office Suite, Excel, Outlook, Word savvy 
  • Knowledge of Medical Terminology, HIPPA Compliant 
  • Knowledge of insurance guidelines especially Medicare and state Medicaid
  • Extremely detailed oriented and excellent organizational and communication skills.
  • Ability to effectively manage multiple priorities simultaneously and meet critical deadlines in a fast-paced environment.  
Experience
AmerisourceBergen/Premiersource Charlotte, NC Billing Specialist Oct 2014May 2015
  • Diagnostic Billing on CMS 1500 Claim form. Provided timely followup on unpaid, denied, and /or short paid claims.  Routinely communicated with health care providers, insurance carriers and patients to obtain, clarify claim information on underpaid or denied claims for re-submission of clean claims. 
  • Posting insurance and patient payments, payment adjustments, preparing claim appeals, research and completed all necessary paper work needed for resolving any claim denials to retrieve payment. 
  • Review accuracy of all demographic information,Ensure that all claims submitted to government and private payers comply with applicable  federal and state regulations.
Novant Charlotte, NC Patient Account Representative (PARIII) Oct 2013Oct 2014
  • Top performance Followup on denial, No response, and rejection Workques for 5+ clinics, A/R management.
  • Maintained frequent phone contact with provider representatives, third party customer service representatives,guanrantor, and patients when necessary.
  • Escalated issues to team lead, Coordinated with RCA to provide all necessary documentation required to expedite payment such as credentialing NPI issues for providers
  • Charge Entry and payment posting.
  • Research claim status with carriers via various web portals, Assess accounts to determine the next appropriate course of action in line with payer guideline and company policy.
  • Accurate timely submission of technical or professional medical claims to insurance companies including physician offices, nursing homes, or other health care facility. 
  • Obtain any missing information,posting both patient and insurance payments and the appropriate adjustments according to the EOBs Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
Wells Fargo Charlotte , NC Loan Document Specialist Mar 2011Jan 2013
  • Audit and Review mortgage loan documents for accuracy including all collateral documents per guidelines. 
  • Request additional documentation to ensure all condition are cleared. 
  • Follow up with borrower to ensure customer satisfaction. Manage daily pipeline. Conventional, FHA/VA Loans
Davis Langston/temp/Robert Half Charlotte, nc Receptionist Sep 2009Jan 2011
  • Primarily responsible for being the first contact with the public through a multi phone line switchboard, and greeting/directing guest with sign in security procedure from the reception desk. Places, receives and routes  a high volume of calls
  • Greets, announces, and guides guest and vendors to appropriate staff or location. Update phone system to reflect change in staff including recordings, staff listings, schedule center conference rooms for usage and ensure appropriate posting.
  • Separates, sort and distributes all incoming mail, packages and faxes. Order and maintain office supply inventory, keep contracts/files on all office equipment
  • Maintain, stock, and organizes reception area, mail room, pantry, and kitchen.
Education
Novant Billing(160HRS)Broad Range of Training Courses Charlotte, NC Externship Nov 2013 Reviewing Claims 100, Guarantor Follow up 100, Statement Coordinator 100, Insurance 101
Insurance Follow-up 101, Insurance Payments 100, Charge Entry 100, Charge Entry & Coding 200,
PBB Charge Entry 100, Guarantor Payment for Clinics, Scheduling 100A,
Scheduling 100B, Scheduling 100C, Front Desk 200, Clinical Support Staff 100, Clinical Staff 200
Claims Coordinator200, Credit Resolution 100,
Claims Coordinator 100
Extensive hands on Epic & Emdeon training in denial, no response, and claim edit WQ's, and spread sheets.
Knowledge of calling insurance companies to check claim status for no response and denial claims.
Shadowing in the Specialty, Family Practice, Coding and RCA departments
Kaplan College Charlotte, NC Diploma: Medical Billing and Coding Feb 2013
Interboro Institute Charlotte , NC Associate of Science: Paralegal Jun 2008
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Resume Details

This is a real resume for a Billing Specialist in Charlotte, North Carolina with experience working for such companies as Amerisourcebergen, Premiersource, Novant. This is one of the hundreds of Billing Specialist resumes available on our site for free. Use these resumes as templates to get help creating the best Billing Specialist resume.

Previous Companies:

  • AmerisourceBergen
  • Premiersource
  • Novant

Previous Job Positions:

  • Billing Specialist
  • Patient Account Representative
  • Loan Document Specialist
  • Receptionist

Schools:

  • Novant Billing(160HRS)Broad Range of Training Courses
  • Kaplan College
  • Interboro Institute

Level of Education:

  • Externship
  • Diploma
  • Associate of Science

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