Billing & Reimbursement Resume Sample

4.6
17 votes
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Unique Glover
828 Kub Springs,  Chicago, IL
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Work Experience


Billing & Reimbursement Specialist
10/2015 - PRESENT
Houston, TX
  • Review of accounts to determine the appropriate adjustment needed for the patient’s Coupon Assistance. Makes adjustment in system. Enters note in system to reflect the action taken. Run reports to balance the Coupon Assistance each day and makes adjustments if needed to balance
  • Prepares and reviews claims to ensure billing accuracy according to payor requirements, including but not limited to codes, modifiers, pricing, dates and authorizations
  • Some cross-functional interaction with billing and cash teams
  • Provides and reviews statistical information relating to payments received
  • Experience; preferably in healthcare or banking industries
  • Review of accounts to determine the appropriate adjustment needed for the patient’s Coupon Assistance. Makes adjustment in system. Enters note in system to reflect the action taken
  • Run reports to balance the Coupon Assistance each day and makes adjustments if needed to balance
Billing Reimbursement Spec
09/2009 - 05/2015
San Francisco, CA
  • Handles complex tasks or urgent problems in addition to daily workload
  • Resource for team to get questions answered. Assists with the training of new employees for specific tasks
  • In healthcare billing and collections setting
  • Proficient knowledge of healthcare terminology and medical billing
  • Use Microsoft Software; specifically Word, Excel (pivots, lookups), Outlook
  • Work under little supervision and mentor other team members when needed
  • Pursues collection activities to obtain reimbursement from payors and/or patients. Contacts payor to request overrides, retro authorizations, additional documentation, window extensions, etc. to ensure invoice has necessary elements for reimbursement or to work a rejected claim (denial)
  • Responds to billing inquiries and questions relating to patient accounts
  • Able to use Excel proficiently and have the ability to do basic math
Billing & Reimbursement Administrative Assistant
04/2007 - 05/2009
Houston, TX
  • Prepares and reviews claims to
  • Detail oriented and strong organizational skills; Self-starter and team player
  • Resolves basic outstanding claims by
  • Possesses complete understanding of the billing/collection process to resolve complex, outstanding claims
  • Escalates delinquent and/or complex claims for appropriate action
  • Outbound collection calls is necessary
  • Collections experience in insurance/healthcare environment
  • Review and process incoming requests from the business regarding billing, pricing, and/or coding requirement changes
  • In absence of supervisor, acts as liaison between staff and manager

Education


Herzing University Madison
2002 - 2006
Bachelor's Degree in Healthcare

Professional Skills


  • Detailed oriented, good organizational skills, good verbal and written communication skills, good email etiquette
  • Basic PC skills, including Microsoft Excel, Word, Outlook, PowerPoint, and the ability to search the internet effectively
  • Organization skills with the ability to prioritize tasks
  • Basic PC skills, including Microsoft Excel, Word, Outlook, PowerPoint and the ability to search the internet effectively
  • Medical billing and effectively using electronic billing systems and analyzing data for variables and errors
  • Recent experience working with SharePoint
  • Deposit/Cash Posting Experience

How to write Billing & Reimbursement Resume

Billing & Reimbursement role is responsible for search, basic, microsoft, etiquette, reporting, training, database, shipping, research, insurance.
To write great resume for billing & reimbursement job, your resume must include:

  • Your contact information
  • Work experience
  • Education
  • Skill listing

Contact Information For Billing & Reimbursement Resume

The section contact information is important in your billing & reimbursement resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:

  • First and last name
  • Email
  • Telephone number

Work Experience in Your Billing & Reimbursement Resume

The section work experience is an essential part of your billing & reimbursement resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous billing & reimbursement responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular billing & reimbursement position you're applying to. The work experience section should be the detailed summary of your latest 3 or 4 positions.

Representative Billing & Reimbursement resume experience can include:

  • Recent experience working in the healthcare industry with claims, benefits or prior authorizations
  • Two Years’ experience in medical insurance environment is helpful, but not required
  • Reliable, self-motivated with excellent attendance
  • Communicating with patients regarding insurance checks
  • Organizing work flow and coordinating activities needed
  • Documenting chart notes accurately

Education on a Billing & Reimbursement Resume

Make sure to make education a priority on your billing & reimbursement resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your billing & reimbursement experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.

Additional details to include:

  • School you graduated from
  • Major/ minor
  • Year of graduation
  • Location of school

These are the four additional pieces of information you should mention when listing your education on your resume.

Professional Skills in Billing & Reimbursement Resume

When listing skills on your billing & reimbursement resume, remember always to be honest about your level of ability. Include the Skills section after experience.

Present the most important skills in your resume, there's a list of typical billing & reimbursement skills:

  • Effectively manage deadlines and client escalations
  • Experience
  • Analyze and interpret local and state policy and procedural guidelines and demonstrate flexibility when those procedures change
  • At least six months of recent experience in the billing and/or collections required
  • Experienced in the use of MS Word and Excel
  • 3 – 5 years of relevant experience working with Medicare/Medicaid on billing/collection/appeals

List of Typical Experience For a Billing & Reimbursement Resume

1

Experience For Billing & Reimbursement Specialist Resume

  • Enters note in system to reflect the action taken
  • Detail oriented and strong organizational skills; Self-starter and team player; Focus on quality and service; Demonstrated ability to meet multiple deadlines and manage a heavy workload; Integrity to handle sensitive or confidential information is critical
  • Speaks with payers regarding payment/account status
  • Generates reports to show account activity
  • LI - NNI
  • COLLABORATE: Able to act as part of a larger team outside of the immediate department or group; Able to understand the importance of working with peers in other areas or management to reach "best practice" solutions for the organization; Able to inform and seek information to anticipate and consider the impact of decisions or actions on the overall organization

List of Typical Skills For a Billing & Reimbursement Resume

1

Skills For Billing & Reimbursement Specialist Resume

  • Working knowledge of basic A/R principles, familiarity in working with health insurance plans, Medicare, Medicaid and Explanations of Benefits (EOB’s)
  • Responsible for accurate billing and collecting of revenue for all financial classes including Commercial, Federal and State insurance plans
  • Responsible for reviewing and addressing incoming mail correspondence
  • Assist with management on special projects including project planning, partnering with internal resources, and presentation of status to management
  • Screens incoming communications for relevancy and importance, then channels them to the next levels within the regulatory team for processing
  • Review and develop communication documents and request workflow processes, utilizing and creating automated tool sets
  • LISTEN: Able to actively listen and convey understanding of the comments and questions
  • Front Desk - Incoming Calls – Customer Service
  • Data entry/record keeping and accuracy and attention to detail required
2

Skills For Billing Reimbursement Specialist Resume

  • Personal computers, create spread sheets, utilize forms and Microsoft Office Applications, including Windows, Word and Excel
  • Some follow up with payors and/or patients on outstanding accounts
  • Monitors the regulatory team’s communication portals (regular mail, JP Morgan box, email, and faxes) for incoming communications
  • Contact Pharma Manufacturers regarding complex payment issues
  • Work in fast-paced, payment processing environment
  • Travel Requirements: <25% Travel
  • Travel Requirements: - Ability to work from home
  • Work independently, exercising good judgment, and multi-task in a high stress, fast paced service environment with patients, patient’s family and insurance carriers
  • DEMONSTRATE SOUND JUDGMENT: Able to make appropriate decisions and has the vision to understand their impact; Able to use factual information to develop logical assumptions; Able to examine alternatives and consider resources, constraints and risks before committing to action
3

Skills For Billing Reimbursement Spec Resume

  • DELIVER QUALITY RESULTS: Able to deliver top quality service to all customers (internal and external); Able to ensure all details are covered and adhere to company’s policies; Able to strive to do things right the first time; Able to meet agreed-upon commitments or advises customer when deadlines are jeopardized
  • THINK STRATEGICALLY: Able to see the "big picture" and be future-thinking; Able to identify trends and offer solutions
  • SOLVE PROBLEMS: Able to apply both rational and creative processes and approaches to identify root causes of problems and solutions
  • INFORM: Able to keep all appropriate parties up-to-date on decisions, changes and other relevant information
  • Patient Pre-certification – Benefit Eligibility
4

Skills For Senior Billing & Reimbursement Specialist Resume

  • Highly proficient in Microsoft office products, specifically Excel, Access, Word and PowerPoint
  • Work cross-functionally to resolve issues and create reports
  • Office or work unit procedures, methods and practices
  • Resolve problems independently and request appropriate supervisory guidance when appropriate
  • Maintain effective, respectful working relationships with all levels of staff and communicate effectively and professionally both orally and in writing, while respecting cultural differences
  • Customer Focus: Connects meaningfully with Independent Contractors & Agencies to simplify complexity and integrates internal efforts to deliver an optimal customer experience
  • Engage in conversations between GHI/Quadax and payers’ operations personnel towards the end of the contract process, and follow up on action items. Assume revenue pull-through responsibility post contract production execution
5

Skills For Billing & Reimbursement Administrative Assistant Resume

  • Reviewing of Explanation of Benefits
  • Allocating coinsurance and deductible appropriately within the database
  • Conducts frequent follow up with payers and/or patients on outstanding accounts
  • Conduct follow up with payers and/or patients on outstanding accounts
  • Prepares and reviews straightforward claims to ensure billing accuracy
  • Intermediate knowledge in the use of MS Word and Excel
  • Transmit claims via electronic software and review the payments
6

Skills For Billing & Reimbursement Resolution Specialist Resume

  • Maintain thorough records of customer communication and payments received
  • Obtain and track claim status via phone and online portals
  • Compose and follow up on claims appeals
  • Build relationships with insurance carriers and representatives
  • Communicate and collaborate with the internal departments
7

Skills For Billing / Reimbursement Associate Resume

  • Pursues basic collection activities to obtain reimbursement from payors and/or patients
  • Escalates delinquent and/or complex claims to Lead Reimbursement Specialist for appropriate action
  • Receives and initially processes requests for assistance with clinical appeals for Core/Oncology a few advanced therapy medications (coagulation factors), then channels them to the next level within the team for further processing
  • Responds to internal requests for clarification/guidance on established guidance and communication, using resources from the Medicare SharePoint site, Drug Database, and others. Acts as a back-up data-entry person for the team for information that needs to be logged and entered into the spreadsheets
  • Sends appeals packages out via web-portal (uploading onto Connex, etc.), Certified mails, regular mail, FedEx or faxes spreadsheet
  • Research/analyze/ correct complex cash posting issues
  • Performs other tasks as assigned by leadership
  • Read remittance from Pharma Manufacturers
8

Skills For HME / DME Billing & Reimbursement Supervisor Resume

  • Team player who has the ability to stay on task with little supervision
  • Review of accounts to determine the appropriate adjustment needed for the patient’s Coupon Assistance
  • Balances report and batches payment information
  • Ensure Client inquiries are addressed and resolved in a timely fashion with increase customer service support
  • Responds to internal requests for clarification/guidance on established guidance and communication, using resources from the Medicare SharePoint site, Drug Database, and others
9

Skills For HME Billing & Reimbursement Coordinator Gilbert Resume

  • Analytical skill-set needed
  • Excellent retention and judgment ability
  • Frequent follow up with payers on outstanding accounts
  • Know when to escalate delinquent and/or complex claims to Sr. Billing & Reimbursement Specialists for appropriate action
  • Acts as a back-up data-entry person for the team for information that needs to be logged and entered into the spreadsheets
10

Skills For Manager of Billing / Reimbursement Resume

  • Reviews claim payment and reconciles unpaid or short paid claims
  • Pursues collection activities to obtain reimbursement from payers
  • Medical Accounts Receivable
  • Maintains HIPPA compliance
  • HIPAA and confidentiality
  • PC and MS Office literate
  • Makes adjustment in system

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