Billing Rep Resume Sample

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17 votes
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Evans Nolan
9583 Kunze Cape,  New York, NY
+1 (555) 530 6338

Work Experience


Senior Billing Rep-new Business
12/2017 - PRESENT
Los Angeles, CA
  • Reasoning Abilities:Exhibits ability to identify errors that could have occurred by others in the Clinic Software to bring to Manager’s attention for resolution and prevent further error in the Hospital software
  • Frequent use of computer, keyboard, copy, fax and scanner machine and the phone
  • Inputs and updates all patient data
  • Prepares, sends and tracks CMN's and prescriptions to physicians
  • Obtains insurance authorization and recertification as needed
  • Maintains accurate and complete records concerning billing activity and inventory tracking
  • Examines insurance explanation of benefits to assure responsibility and identify rejected insurance billings. Rework and rebill rejected accounts in a timely manner
  • Proficient in written and spoken English language
Billing Rep
04/2014 - 08/2017
Boston, MA
  • Bill all primary commercial claims on the SJHS claims management system print to paper, if appropriate, with necessary edits to ensure compliant billing practices. Report any variances in workload to the PFS Manager
  • Review claims for accuracy and completeness, collecting and verifying all documentation necessary for timely billing of patient accounts, including requesting and collecting medical records and other documents ensuring the acceptance of the claim
  • Work all reports related to billing, such as worklists, hold reports, and rejection reports to ensure claims are submitted timely and accurately, per department guidelines
  • Identify recurring errors and corrections being made to claims and report these to the PFS Manager. Make recommendations to resolve problems
  • Complete all secondary billing and rebilling. Ensure required attachments, such as remittance advices or explanation of benefit forms are appropriately attached, if required
  • Resolve rejected claims and perform rebilling as needed
  • Accurately document actions taken in the system of record to drive effective follow-up and ensure an accurate audit trail
Special Billing Rep
10/2009 - 01/2014
Dallas, TX
  • Maintain ongoing knowledge of commercial billing requirements and payor guidelines. Keep current with knowledge of facility payor contracting agreements. Understand billing timelines and urgency in meeting all claims and filing deadlines
  • Act as a knowledgeable resource on commercial billing functions for department staff. (e.g., answer account questions, assist with new staff training
  • Return phone calls and leave messages for customers in a timely fashion. Maintain a fundamental understanding of patient information available on Athena and legacy systems
  • Able to identify errors on patient accounts and make corrections appropriately. Follow up on customer requests for refiling of claims in a timely manner
  • Acts as a site resource
  • Work with Information Technology and Business Intelligence departments and customers to create custom billing formats that meet customers’ unique requirements
  • Verifies meter postage on a daily basis. Processes the check for USPS when postage is needed. Reviews daily 3600’s for USPS stamp, enters/imports information into the POInTS system and maintains a file. Captures permit postage and distributes to the appropriate job

Education


Indiana Wesleyan University - Kokomo Campus
2004 - 2009
School's Degree in Computer

Professional Skills


  • Post payments, adjustments, and denials per EOB’s, including recoup payments and notifications timely, and accurately. Comply with payers and providers’ contracts as well as National and Local Policies and Procedures. Confirm with payer website EOB’s, if electronic remit does not balance or appears to have posting concern
  • Demonstrate communication skills: using appropriate vocabulary and grammar
  • Intermediate Excel Skills – Pivot Tables & V-Lookups
  • Exercise skill in prioritizing assignments in order to complete work in a timely manner when there are changes in workload, assignments
  • Experience following up on claim status, resolving denials & rejections, re-billings, re-submitting claims, & filing appeals
  • Experience posting insurance and patient payments, cash applications, cash posting (nation of Benefits, EOB, EFT, lock box)
  • Medical Billing or Medical Administrative experience

How to write Billing Rep Resume

Billing Rep role is responsible for insurance, benefits, customer, referrals, ease, case, reporting, credit, training, purchasing.
To write great resume for billing rep job, your resume must include:

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

Contact Information For Billing Rep Resume

The section contact information is important in your billing rep 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 Rep Resume

The section work experience is an essential part of your billing rep 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 rep 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 rep position you're applying to. The work experience section should be the detailed summary of your latest 3 or 4 positions.

Representative Billing Rep resume experience can include:

  • Experience: 2 year of relevant work experience in Billing or Accounting (in addition to education requirement)
  • Review goods movements for orders crossing state lines as needed to ensure information required to properly capture taxes is recorded
  • Office experience utilizing electronic information technology required
  • Demonstrates the ability to obtain insurance verifications and authorizations utilizing on-line or by phone when required
  • One (1) years of experience
  • Able to operate basic office equipment

Education on a Billing Rep Resume

Make sure to make education a priority on your billing rep resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your billing rep 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 Rep Resume

When listing skills on your billing rep 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 rep skills:

  • Calls are answered as quickly as possible and with the proper intake greeting utilizing customer service skills at all times
  • Copy EOB’s for refunds and/or priority alerts to follow-up as needed (massive denials, payer paid or approved 100% of charge amount, etc.)
  • Experience in verifications systems, POS terminal, and/or Banner
  • Experience in telecom or cable required
  • Clinical laboratory, physicians office, and/or customer service experience
  • 1 – 2 years’ related experience

List of Typical Experience For a Billing Rep Resume

1

Experience For FGP Billing Rep Resume

  • Coordinates and validates claims transmitted to ensure edit criteria is met
  • Lift up to 50 #’s, walk stand or sit for long periods of time with or without accommodation
  • Review order information within SAP, Interactive Marketplace and on incoming delivery documents to ensure orders have been finalized by the Dispatch department to enable invoicing
  • Provides information to referral sources regarding programs and services available to meet customer’s needs. Communicates the specific needs of the client and the available service to the appropriate source. Answer all questions correctly and utilizes intake resources when needed to assure information is correct
  • Assists in the handling of customer’s financial matters, i.e. insurance coverage or not, and makes arrangements for payment. Customers are contacted and notified of financial responsibility and financial matters are resolved in a timely and appropriate manner
  • Requests additional information if claim is inaccurate or incomplete either by contacting patients and/or physician offices to obtain information as needed. Analyzes and reports on repetitive edit failures so that corrective action can be taken
2

Experience For Special Billing Rep Resume

  • Performs re-bills as necessary
  • Takes appropriate action to follow up when claims fail edits
  • Maintains documentation of claims processed as part of the daily claims reconciliation process
  • Consults with appropriate personnel to resolve unbilled claims
  • Performs collection Functions and financial assistance for payment methods
3

Experience For Customer Svc & Billing Rep Resume

  • Collect and/or negotiate point of service payments or link to financial assistance programs
  • Convey estimates of the patient responsibility portion of the billed cost of service to patients under deductible, coinsurance, and standard co-pay benefit designs based on established charge estimates for common procedures
  • Review and monitor accounts for inpatients and initiate proper action
  • Process patient accounts and deploy established policies to resolve insurance issues with patient accounts with/without supervision i.e. conference calls with employer, payer and physician office staff
  • Audits invoices to prepare a centralized bill for 8 to10 standard bill. National account customers
  • Healthcare Collection: 1 year
4

Experience For Payment Poster / Billing Rep-cash Data Resume

  • Interpret and discuss insurance explanations of benefits and payments
  • Research and attention to detail
  • Complimentary Company Services
  • Assists customers with obtaining and/or the completion of required medical documentation or other paperwork. Collects data and appropriate information for patient’s file. Customers are given complete and accurate information. The information is communicated to the customer in a clear and concise manner. Questions are answered or directed to the appropriate source

List of Typical Skills For a Billing Rep Resume

1

Skills For FGP Billing Rep Resume

  • Previous experience within a dental, medical or higher education environment
  • Previous experience with Axium
  • Multitask, prioritize work, and make independent decisions for non-complex issues
  • Understanding of ICD-10 and CPT necessary
  • Medical Biller is responsible for updating patient accounts with registration, insurance, demographic, scheduling, and billing data
  • Maintain filing system for overpayment/recoup notifications and negative EOB’s. Post transactions in appropriate account balancing with the EOB
2

Skills For Special Billing Rep Resume

  • Extraordinary team environment with weekly one on one coaching with management, team incentives and ongoing support from our leadership staff
  • Interacts with customers in a courteous and compassionate manner. Receives incoming telephone calls from customers and/or referral sources requesting services
  • Answers telephone according to standard operating procedures and policies
  • Medical Biller is responsible for performing full cycle medical billing for multispecialty physician and hospital services
  • Counsels patients regarding their third-party coverage, financial responsibility, and billing procedures
  • Remain current on changes in billing and payment requirement for all third party payers
  • Familiar with CPT Coding/Medical Terminology
  • Reviews recent accounts for proper billing practices and reimbursement
  • Provides input on system edits, processes, policies and billing procedures to ensure maximization of revenues
3

Skills For Customer Svc & Billing Rep Resume

  • Identifies payer and provider credentialing issues and addresses them with manager
  • Check patient eligibility while working on edits in the Epic system
  • Accounts Receivable Follow upEnsure and monitor all outstanding Accounts Receivable is process and reimburse in a prompt and timely manner
  • Provides information to referral sources regarding programs and services available to meet customer’s needs
  • Collect on insurance and patient outstanding balances
  • Establish payment plans, accept payment, and work aging reports
  • Review patient account summaries of unbilled charges, billing, payments, and collection activities
4

Skills For Payment Poster / Billing Rep-cash Data Resume

  • Obtain all forms required for patients potentially qualifying for financial assistance
  • Healthcare Billing: 2 years
  • Knowledge of basic healthcare billing/collection practices, third-party payer reimbursement policies and HIPAA
  • : Accounts Receivable/Billing
  • Calculates balance due for reporting to secondary insurance company based on previous payments and adjustments
5

Skills For Residential Billing Rep Resume

  • Performs daily tasks in assigned workqueues and according to manager assignments
  • Maintains detailed documentation in the patient account record of all billing activities
  • Maintain knowledge of what we are contractually obligated to adjust, payers, bankruptcies, collection agency, workers’ compensation, etc
  • Maintains patients’ and employees’ privacy and confidentiality
  • Code and process member payments
  • Prepares third party billing of Medicare, Medicaid, Blue Cross, Champus, HMO’s, PPO’s, POS’s Workers’ Compensation and Special Contracts
6

Skills For Commercial Care Billing Rep Resume

  • Prepare billing for recurrent accounts, Audit treatment and/or encounter dates for Medicare and Medicaid claims to ensure the 72 hr and Lab compliance rules not violated
  • Use initiative and independent judgment in the performance of work
  • Knowledge of HMO’s , PPO’s, Commercial/Governmental payers and System/Entity specific hospital contracts with Third Party payers
  • Basic knowledge of HIPPA and EMTALA
  • Knowledgeable in claim denials/appeals
  • Adept in Microsoft Office applications
7

Skills For FGP Billing Rep-queens Resume

  • Possess comprehensive understanding of Insurance billing and follow-up practices and Hospital Information System functionality in order to adequately address account issues. 1 year of Healthcare billing/collections experience required
  • Consults with appropriate parties to resolve unbilled claims
  • Performs daily tasks in assigned WQ’s
  • Processes referral source requests and analyzes the computer data of customer’s basic information to determine appropriate course of action for completing paperwork. Enters data in the computer system and obtains missing information
  • Medical data is processed and accurately analyzed in a timely manner in accordance with billing standards and payor guidelines
  • Maximizes reimbursement through accurate order entry/submission billing
  • Collects data and appropriate information for patient’s file
  • Ensures customers are given complete and accurate information. The information is communicated to the customer in a clear and concise manner. Questions are answered or directed to the appropriate source
8

Skills For Production Billing Rep Resume

  • Communicates the specific needs of the client and the available service to the appropriate source
  • Answer all questions correctly and utilizes intake resources when needed to assure information is correct
  • Provides assistance and guidance to customers
  • Has current knowledge of Medicare reimbursement criteria and insurance contracts for MAH/HIU product lines
  • Demonstrates use of customer service skills to network with insurance payor case managers to assure ease of referrals for MAH/HIU services when requested. Obtains complete & accurate verifications of patient’s insurance benefits & works with insurance payor to obtain all authorizations as necessary
9

Skills For Billing Rep-sbs Resume

  • Assists other staff members as needed, by completing various tasks as requested (i.e., coordinates deliveries/pickups with Patient Service Techs)
  • Tasks are completed in an accurate and timely manner. Provides phone support, relays messages to the appropriate party and takes messages as needed
  • Has current knowledge of Medicare reimbursement criteria and insurance contracts for HMH/HIU product lines
  • Demonstrates use of customer service skills to network with insurance payor case managers to assure ease of referrals for HMH/HIU services when requested. Obtains complete & accurate verifications of patient’s insurance benefits & works with insurance payor to obtain all authorizations as necessary
  • Assists other staff members as needed, by completing various tasks as requested (i.e., coordinates deliveries/pickups with Home Care Delivery Techs)
10

Skills For Senior Billing Rep-new Business Resume

  • Has current knowledge of Medicare reimbursement criteria and insurance contracts for HMH At Home product lines
  • Demonstrates use of customer service skills to network with insurance payor case managers to assure ease of referrals for HMH At Home services when requested. Obtains complete & accurate verifications of patient’s insurance benefits & works with insurance payor to obtain all authorizations as necessary
  • Medical Biller creates, submits, and processes government, Medicare, Medicaid, and commercial insurance claims
  • Medical Biller is responsible for management of accounts receivable and accounts payable
  • Obtain insurance verification, precertification, and authorization via phone and insurance payer portals

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