Highly experienced and detail-oriented medical biller with over 15 years of experience in managing billing operations, ensuring accurate coding, and maximizing reimbursements for healthcare providers. Proficient in various medical billing software and well-versed in ICD-10, CPT, and HCPCS coding systems. Proven track record of improving revenue cycle management and maintaining strong relationships with insurance companies and healthcare providers.
08/2015 - present, Senior Medical Biller, HealthFirst Medical Group, San Antonio, TX
- Manage billing operations for multi-specialty medical group with 25+ providers serving thousands of patients.
- Ensure accurate and timely submission of claims to private insurance companies, Medicare, and Medicaid.
- Resolve complex billing issues and manage appeals process to reverse denial of payment decisions.
- Train and supervise a team of five medical billers on policies, processes, and procedures.
- Implemented new billing software, resulting in 20% increase in reimbursements.
06/2010 - 07/2015, Medical Biller, Alamo City Orthopedics, San Antonio, TX
- Processed insurance claims for orthopedic practice with 10 providers and large patient base.
- Conducted timely follow-up of unpaid claims and appealed denied claims.
- Assisted patients with billing inquiries and payment plans.
- Maintained 98% clean claim rate.
03/2005 - 05/2010, Billing Specialist, Riverwalk Pediatrics, San Antonio, TX
- Performed billing and coding for busy pediatric practice.
- Verified patient insurance eligibility and obtained prior authorizations.
- Collaborated with practice manager to improve billing workflows.
- Reduced accounts receivable aging from 60 to 30 days.
- Medical Billing Software
- ICD-10
- CPT & HCPCS Coding Systems
- Medical Terminology
- Denials & Appeals
- Electronic Health Records (EHR) / Electronic Medical Records (EMR)
- Private Insurance Plans
- Medicare & Medicaid
- Reimbursement Procedures
- HIPAA Compliance
- Communication Skills
- Problem-Solving
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