Medical Billing Specialist
Professional Resume Example
Professional Summary
Highly diligent and results-oriented Medical Billing Specialist with 5+ years of experience in optimizing revenue cycle management for multi-specialty clinics. Proficient in claim submission, denial resolution, and accurate CPT/ICD-10 coding. Adept at leveraging advanced billing software to enhance operational efficiency and reduce accounts receivable aging, ensuring HIPAA compliance and maximizing reimbursement rates.
Work Experience
Senior Medical Billing Specialist
St. Jude's Healthcare System
- Managed the end-to-end submission of over 800 medical claims weekly, achieving a first-pass clean claim rate of 97% using Epic and Waystar platforms.
- Reduced outstanding accounts receivable by 15% within six months through diligent follow-up and successful appeals for denied claims, recovering over $120,000 annually.
- Generated weekly and monthly financial reports for management, identifying trends in payment discrepancies and contributing to a 10% reduction in billing errors.
- Mentored two junior billing specialists, improving team productivity by 20% in denial management processes and fostering best practices in coding accuracy.
Medical Billing Specialist
Summit Family Practice
- Assigned accurate CPT, ICD-10, and HCPCS codes for an average of 150 patient encounters daily, ensuring 99% coding accuracy across diverse specialties.
- Verified patient insurance eligibility and obtained prior authorizations for high-cost procedures, resulting in a 30% decrease in claim rejections due to lack of authorization.
- Posted insurance and patient payments totaling over $75,000 monthly with a 99.5% accuracy rate, efficiently reconciling discrepancies and maintaining detailed records.
- Addressed patient billing inquiries and negotiated payment plans for over 50 accounts monthly, reducing patient outstanding balances by 10% and improving patient satisfaction scores.
Skills
Education
Associate of Science in Medical Office Administration
Central Valley Community College
Certifications
- • Certified Professional Biller (CPB) – AAPC
- • Certified Medical Administrative Assistant (CMAA) – NHA
Frequently Asked Questions
What certifications are most valuable for a Medical Billing Specialist?
The Certified Professional Biller (CPB) from AAPC is highly regarded by employers, demonstrating expertise in medical coding and billing. Additionally, the Certified Billing and Coding Specialist (CBCS) from NHA can also boost your credentials and demonstrate comprehensive industry knowledge.
How important is knowing specific billing software?
Extremely important. Hiring managers actively look for candidates proficient in industry-standard systems like Epic, Waystar, Kareo, or AdvancedMD. Listing specific software on your resume ensures ATS compatibility and immediately shows your readiness to integrate into a new role effectively.