Gautier, MS 2017 to present
Singing River Health System prides itself with passion and commitment to improve health and save lives in the community every day.
Insurance Billing Specialist
• Prepares Medicare, Medicaid, Managed Care, and private insurance claim for billing
• Researches and resolves payment discrepancies, denials, and appeals
• Review charges for accuracy and billing compliance
• Maintains acceptable goals for outstanding AR and cash receivables
• Confirms patient eligibility and benefit verification when required to determine correct order of payor benefits
• Provides input and feedback to Manage, staff, and other departments to resolve billing and reimbursement issues
- Insurance Billing Specialist at Singing River Health System
- Team Coordinator/Volunteer Coordinator at Compassus Hospice
- Bill Review Manager, Mississippi at CORVEL
- Bill Review Analyst at CORVEL
2 years at this Job
- Diploma - Certified Self Insured Worker
As a Insurance Billing Specialist, I input all of the electronic and paper claims into our computer software. I input new ICD-10 codes for the patients diagnosis so it can be sent in to the insurance companies. I assist patients with therapies.
- Insurance Billing Specialist at Ozark Chiropractic Clinic
- Cashier at Cvs Family Foods
1 month at this Job
- Associate - Health Information Technology
- High school
Insurance Billing Specialist, January 2019-Present
Spartanburg Regional Hospital, Spartanburg, SC
• Responsible for all Medicare and Medicare HMO pre-bill edits and claim scrubber edits for accuracy and compliance.
• Manage daily Medicare work queues in Epic system for claim, account and patient edits.
• Generate new claims through Epic by entering the account number, resubmitting the claim and selecting whether to bill primary or secondary insurance.
• Generate corrected claims that have coding, demographics or updated charges through Epic.
• Ensure timely submission of professional 1500s andhospital UB04 claims created in Epic to insurance companies.
• Infix information necessary for insurance claims such as patient demographics, diagnosis and treatment codes, modifiers, and provider information obtained from Epic, Registration and ePremis.
• Analyze claims for appropriate ICD9, ICD10, revenue codes and modifiers.
• Formulate necessary arrangements for Medicare non-billable accounts and NRP any bucket balances under two hundred dollars.
• Manage claims in Medicare system DDE that have rejected, denied or need to be suppressed and have a new claim billed.
• Ensure completion of referral accounts, late charges, and adjustment from various Revenue Cycle departments.
• Responsible for multiple daily reporting of billing indicators through various reporting tools.
- Insurance Billing Specialist at Spartanburg Regional Healthcare System
- Billing Specialist at Ensemble Health Partners
- Diagnosed member at United HealthCare-Optum
- Mental Health Youth Advisor Intern at Mental Fitness Inc
1 month at this Job
- Bachelor's Degree - Psychology
As a Medical Billing Specialist, I was responsible for applying cash receipts, tracking and organizing insurance billing documentation, and assisting with collections.
• Complete billing of a high volume of medical claims through Electronic Medical Records while adhering to Timely Filing Requirements
• Billing of secondary insurance through paper claims
• Knowledge of Medicaid and Commercial insurance carriers billing requirements
• Understand Explanation of Benefits "EOB"
• Understanding of Commercial Insurance contract language/rates per fee schedules and application
• Authorization Request with new CPT codes( 97151-97158)
• Assist clients with insurance claim resolution/
• Process payments over phone
• Ensure billing systems are updated with current contracted fee schedules
- Insurance Billing Specialist at Holding Hands Inc
- Intake Coordinator at
- Billing/Front Desk Specialist at Morningside Pediatrics
10 months at this Job
Input of data to bill insurance companies, using ICD 10 coding. Data entry, customer service: Entering charges and payments. Checking in patients verifying their information for our system and to bill insurances. Referral Specialist: Calling insurance to verify coverage and to check on coverage, also to check for prior authorizations. Back up reception: answering multi-line phone system, making sure phones are answered in a timely and professional manner. As a medical practice, we all wear many hats and cross train in all area's in case someone is out there will always be coverage. Knowledge of multiphone systems, ICD 10 coding, batch processing and balancing. Accounts receivable, posting payments, balancing deposits. Billing insurance companies. Extensive use in Med ware and Amazing charts billing systems. Alpha-numeric chart systems, yearly purging of old charts. HIPPA compliant.
- Insurance billing specialist at LOWER COLUMBIA CLINIC
- Barn sales at COUNTRY CRAFTERS
- CLASS ROOM, CAFERTERIA ASSISTANT at ASTORIA SCHOOL DISTRICT
- File clerk at ASTORIA CLINIC
7 years, 11 months at this Job
Patient Account Resolution Specialist My responsibilities in my last job was: work in a peace environment, filing claims, verifying Patient Benefits and/or information,CUBS system. Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form Customer Service/Refile corrected claims/Post patient payments Resolve issues with insurance companies on unpaid or rejected claims Prepare appeal letters to insurance carrier when not in agreement with claim denial May periodically create insurance or patient aging reports using the medical practice billing software Understands managed care authorizations and limits to coverage such as the number of visits Verify patient benefits eligibility and coverage
- Insurance Billing Specialist at Firstsource Company
- Retail Cashier at Gap Body
- Customer Service at Miami Marketing Association
1 year, 8 months at this Job
- High School Diploma - General
Responsibilities Reviews, Researches and accurately processes claims for billing in accordance with insurance policies. Coding and claims edit reporting utilizing ICD 10, HCPCS and current CPT ; charge entry; patient payment posting;insurance verification; statistical reports for population health; a/r ; UVT testing and problem solving for electronic practice management application. Chart documentation auditing and providing results report for formal review.
- Insurance Billing Specialist at Holy Cross Health Network
- Reimbursement Specialist/ Provider Relations Coordinator at Meridian Financial Management
- Billing Manager; Front Desk at Muneses Chiropractic Center
- Customer Service; Outside Sales at Empire Auto Parts
3 years, 8 months at this Job
- Diploma - Medical Assistant Program
- CPC - Coding and Billing
Operate NexTech program for patient data entry, scheduling appointments, entering/applying co-payments, and exporting financial/insurance reports. Contact and work with all insurance companies to verify benefits and obtain authorizations. Electronically submit claims through software programs and print paper claims for insurance companies which do not accept them electronically. Follow up on submitted claims, monitor unpaid claims, and resubmit claims as necessary. Total daily revenue and complete daily reports for billing management.
- Insurance/Billing Specialist at Lakhani Eye Associates
- Front Office Reception & Billing at Thompson Healthcare & Sports Medicine
- Medical Front Office Coordinator at Lakeside Vision
- Reservation & Front Desk Specialist at The Lodge At Woodloch - A Destination Spa
1 year, 6 months at this Job
- Bachelor of Business Administration and Human Resource Management - Management
• Entering billing therapist timesheets with ICD-10 and CPT codes.
• Adjudicating claims and troubleshooting rejected and denied claims
• Assist with inbound/outbound calls for payment and collections
• Enter and update patient demographics
• Calls to various insurance carriers for patient eligibility information
• Submitting for prior authorizations, new and current renewals
- Insurance Billing Specialist at CI PEDIATRIC THERAPY CENTERS
- Insurance Billing Specialist at RESTORE HEALTH PHARMACY
- Bartender at PRIDE OF AMERICA
- Bartender at BRONCO BILLY'S
2 years, 11 months at this Job
1. Responsible for all insurance verifications. 2. Making appointments and keeping a timely, effective, high production schedule. 3. Handle all incoming insurance and patients accounts receivable. 4. Billing out all insurance, inputing all payments into Dentrix, collecting balances owed by patients and insurances. 5. Efficient in all PPO, HMO and Medicaid insurancs. 6. Help with sterilization and flipping rooms. 7. Present treatment plans to all patients.
- Insurance Billing Specialist at Akel Dental
- Receptionist/Accounts Payable at Evergreen Woods Health and Rehab
- Finance Manager at Barneys Motorcycle and Marine
2 years, 7 months at this Job
- Associate of Arts - Criminal Justice