Download Free Sample Resume for Medical Billing Specialist

A well-organized and effective resume is crucial for a Medical Billing Specialist role. It should clearly communicate the candidate's skills relevant to the key responsibilities of the job.

Common responsibilities for Medical Billing Specialist include:

  • Reviewing and verifying accuracy of billing and coding
  • Preparing and submitting claims to insurance companies
  • Resolving billing issues and denials
  • Following up on unpaid claims
  • Posting payments and adjustments
  • Maintaining billing records and reports
  • Ensuring compliance with billing regulations
  • Communicating with patients and insurance companies
  • Updating patient accounts
  • Analyzing and reconciling billing data
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John Doe

Medical Billing Specialist

john.doe@email.com

(555) 123456

linkedin.com/in/john-doe

Professional Summary

Dedicated and detail-oriented Medical Billing Specialist with over 5 years of experience in healthcare administration. Proficient in medical coding, billing processes, and insurance claims. Skilled in optimizing revenue cycle management through accurate coding and efficient billing practices. Adept at resolving billing discrepancies and ensuring compliance with healthcare regulations. Strong communication and problem-solving skills with a proven track record of improving billing efficiency and reducing denials.

WORK EXPERIENCE
Medical Billing Specialist
June 2018 - Present
ABC Healthcare | City, State
  • Review and analyze medical documentation to assign appropriate diagnostic and procedural codes for billing purposes.
  • Submit electronic and paper claims to insurance companies and follow up on outstanding claims.
  • Achieved a 15% reduction in claim denials by implementing a proactive denial management process.
  • Collaborate with healthcare providers to ensure accurate and timely submission of claims.
  • Conduct regular audits to identify billing errors and discrepancies, resulting in a 10% increase in revenue collection.
Medical Billing Coordinator
March 2015 - May 2018
DEF Medical Center | City, State
  • Processed patient invoices and statements, ensuring accuracy and compliance with insurance regulations.
  • Resolved billing inquiries from patients, insurance companies, and internal staff in a timely manner.
  • Implemented a new billing software system, leading to a 20% improvement in billing efficiency.
  • Conducted training sessions for staff on proper billing procedures and coding guidelines.
  • Reduced accounts receivable aging by 25% through effective follow-up on unpaid claims.
Medical Billing Assistant
January 2013 - February 2015
GHI Clinic | City, State
  • Verified insurance coverage and obtained pre-authorizations for medical procedures.
  • Posted payments and adjustments to patient accounts with a high level of accuracy.
  • Streamlined the billing process by identifying and eliminating redundant steps, resulting in a 30% reduction in processing time.
  • Assisted in the preparation of financial reports and analysis of billing data.
  • Received Employee of the Month award for outstanding performance in billing accuracy and efficiency.
EDUCATION
Bachelor's Degree in Healthcare Administration, XYZ University
Jun 20XX
SKILLS

Technical Skills

Medical coding (ICD-10, CPT), Billing software (e.g., Epic, Medisoft), Insurance verification, Revenue cycle management, Electronic health records (EHR), Accounts receivable management, Denial management, Medicare and Medicaid billing, Compliance with HIPAA regulations, Microsoft Excel

Professional Skills

Attention to detail, Communication skills, Problem-solving, Time management, Teamwork, Adaptability, Customer service, Organizational skills, Analytical thinking, Stress management

CERTIFICATIONS
  • Certified Professional Coder (CPC)
  • Certified Billing and Coding Specialist (CBCS)
AWARDS
  • Employee of the Month
  • GHI Clinic - May 2014
OTHER INFORMATION
  • Holding valid work rights
  • References available upon request

Key Technical Skills

Advanced Medical Coding
Billing Software Mastery
Revenue Cycle Management
Compliance Knowledge
Auditing
Advanced Claims Processing
Denial Management
Charge Capture
Payment Variance Analysis
Financial Reporting
Payer Contract Management
Appeals Process
Medical Necessity Documentation
EDI (Electronic Data Interchange) Management
Fraud and Abuse Prevention

Key Professional Skills

Problem-Solving
Leadership
Analytical Thinking
Customer Service Excellence
Interdepartmental Communication
Time Management
Attention to Detail
Adaptability
Negotiation
Training and Mentoring
Ethical Decision-Making
Stress Management
Continuous Learning
Project Management
Cultural Sensitivity

Common Technical Skills for Medical Billing Specialist

  • Advanced Medical Coding: Expertise in ICD-10, CPT, and HCPCS coding, including complex cases and specialties.
  • Billing Software Mastery: Proficient use of multiple billing systems and ability to train others.
  • Revenue Cycle Management: Understanding the complete revenue cycle from patient registration to payment receipt.
  • Compliance Knowledge: In-depth understanding of healthcare regulations like HIPAA, MACRA, and the Affordable Care Act.
  • Auditing: Conducting internal audits to ensure coding accuracy and compliance.
  • Advanced Claims Processing: Managing complex claims and resolving intricate billing issues.
  • Denial Management: Analyzing denial patterns and implementing strategies to reduce claim rejections.
  • Charge Capture: Ensuring all billable services are accurately captured and coded.
  • Payment Variance Analysis: Identifying and resolving discrepancies between expected and received payments.
  • Financial Reporting: Generating and interpreting comprehensive billing and revenue reports.
  • Payer Contract Management: Understanding insurance contracts and their impact on billing.
  • Appeals Process: Managing the appeals process for denied claims, including writing appeal letters.
  • Medical Necessity Documentation: Ensuring proper documentation to support medical necessity for billed services.
  • EDI (Electronic Data Interchange) Management: Overseeing electronic claim submission and remittance processes.
  • Fraud and Abuse Prevention: Identifying potential fraudulent billing practices and implementing preventive measures.

Common Professional Skills for Medical Billing Specialist

  • Problem-Solving: Resolving complex billing issues and implementing process improvements.
  • Leadership: Guiding junior staff and contributing to departmental strategies.
  • Analytical Thinking: Interpreting billing data to identify trends and opportunities for improvement.
  • Customer Service Excellence: Handling escalated patient and provider inquiries with professionalism.
  • Interdepartmental Communication: Effectively liaising between clinical, administrative, and finance departments.
  • Time Management: Balancing multiple priorities and meeting critical deadlines.
  • Attention to Detail: Maintaining high accuracy in complex coding and billing scenarios.
  • Adaptability: Quickly adjusting to changes in healthcare regulations and billing practices.
  • Negotiation: Working with insurance companies to resolve payment disputes.
  • Training and Mentoring: Developing and delivering training programs for billing staff.
  • Ethical Decision-Making: Navigating complex ethical situations in medical billing.
  • Stress Management: Maintaining composure and efficiency during high-pressure periods.
  • Continuous Learning: Staying updated on industry trends and pursuing relevant certifications.
  • Project Management: Overseeing billing-related projects and implementations.
  • Cultural Sensitivity: Understanding and respecting cultural differences in patient communication and billing practices.
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