medical billing specialist - FUSION - Remote
(2025-04)
- Claim Preparation & Submission – Accurately prepare, review, and submit electronic and paper insurance claims through designated billing platforms. Ensure all claims are appropriately coded (ICD-10, CPT, HCPCS) and fully compliant with payer-specific requirements to support timely reimbursement.
- Insurance Verification – Conduct thorough verification of patient insurance coverage and eligibility prior to services. Document co-pays, deductibles, prior authorizations, and benefit limitations to support accurate billing and patient communication.
- Payment Posting – Efficiently post insurance and patient payments to the correct accounts. Reconcile daily deposits and maintain accurate account balances to support revenue integrity.
- Accounts Receivable Follow-Up – Manage follow-up on outstanding, denied, or underpaid claims. Initiate resubmissions, corrections, and appeals to resolve discrepancies and secure proper payment from payers.
- Patient Billing & Support – Prepare patient statements and address billing inquiries with professionalism and clarity. Establish payment arrangements when appropriate and oversee recovery of overdue balances.
- Compliance & Documentation – Maintain strong working knowledge of payer policies, HIPAA guidelines, and all relevant regulatory requirements. Ensure precise documentation of all billing activities within patient records to support compliance and audit readiness.
- Cross-Functional Collaboration – Partner with providers, coders, insurance representatives, and internal departments to resolve billing issues and ensure the accuracy of patient accounts. Foster clear communication to streamline the revenue cycle.
- Reporting & Analysis – Generate and interpret billing and accounts receivable reports to track key revenue cycle metrics. Identify trends, variances, and improvement opportunities to support operational efficiency.
Surgical Scheduler/Patient Account Specialist
(2019-10 - 2024-03)
- Interfaces with appropriate vendor staff to ensure all necessary equipment will be on site for office and hospital-based procedures, including scheduling with contracted anesthesia groups.
- Prepare the facility by ensuring that necessary equipment is scheduled and in the correct room and by continually maintaining surgical inventory.
- Schedules all emergencies and add-on surgeries, patient appointments, surgeries, and administer appointment reminders to patients.
- Schedule emergency and add-on surgeries.
- Provides accurate, detailed information to patients regarding test preparations, time of patients scheduled arrival, and any other directional information needed; takes appropriate action in responding to questions from patients.
- Manage all surgical documents, gather, and input patient information, and enter all post-surgery data while ensuring that all pre-surgery paperwork is completed in time for the patient's appointment.
- Oversee incoming and outgoing phone calls and emails and assist with management at the front desk as well.
- Strong knowledge of clinical maturity, hospital operations, and community resources.
- Performs all aspects of patient care in an environment that organizes patient safety and reduces the likelihood of medical/health care errors.
- Verifies insurance prior to patient's arrival, to include "Add On's and Direct Admits".
- Obtains pre-certification from insurance companies for procedures that require pre-certification.
- Requests office notes from referring physician if needed for Authorization.
- Calculating and Informing patients of amount due.
- Ensures all required forms are placed in designated areas of the patient's chart.
- Daily preparation of charts for next day's surgeries within the required deadline (NO LESS than 3 days prior to surgery, for all cases scheduled four days or more in advance of surgery date).
- Preparation of medical consents for each chart prepared.
- Labeling necessary documents and adding physician orders.
- Out-bound collection calls to patients regarding their medical invoice/bill answering questions and setting up payment/payment plans.
- Utilization of various collection strategies and methodologies to contact consumers to negotiate payment in full or payment arrangements on debt within federal, state and client collection guidelines and laws.
- Knowledge of health care financing and Medical Collections, along with OSHA and HIPAA regulations.
TITLE ORDER SPECIALIST - ROSENBERG & ASSOCIATES, LLC - 4340 EAST WEST HIGHWAY #600 BETHESDA, MD 20814
(2016-06 - 2019-10)
- Process open settlement files.
- Independently conducts research for files.
- Knowledgeable user of the Government's office and network environment, including but not limited to, word processing, databases, spreadsheets, imaging, and telecommunications systems.
- Obtains and review necessary documentation for settlements.
- Perform indexing for legal records and provide updates to all parties on status of settlement.
- Perform quality check related to review of documents for accuracy.
- Performs typing assignments.
- Reviews all Title Abstract and Chain of Title, and outstanding Title issues.
- Enter data on-line to case files and other databases; proofreading, editing, correcting OCR'd text files.
- Schedules settlement with all parties and mobile closer.
- Perform and maintain electronic inventory tracking.
- Performs documents distribution and control (electronically and/or physically).
- Prepare all documents for settlements, and Title commitments.
- Assemble/disassemble documents as required.
- Prepares documents for barcoding, bates, stamping image scanning; performs other document collection related activities, including document screening, and labeling of files to be scanned.
CUSTOMER ADVOCATE - RIGHTTIME MEDICAL CARE - 2225 DEFENSE HIGHWAY CROFTON, MD 21114
(2018-01 - 2019-02)
- Handle calls from new and existing patients and other customers regarding variety of requests.
- Facilitated outbound calls that provided customer service feedback on their experience.
- Maintained and improved quality results by adhering to standards and guidelines recommended to improved procedures.
- Assisted with required reporting as directed by management. Assisted CRC with documenting emergency room transfers when needed and ensure established guidelines were met.
- Monitored the availability of appointments times and notifying management if times fall outside the established range.
CUSTOMER RELATION REPRESENTATIVE - UNIVERSITY OF MARYLAND UNIVERSITY COLLEGE - ADELPHI, MD 20782
(2015-08 - 2017-12)
- Provided instruction and guidance in operation and procedures to the team and procedures for the team while coordinating work priorities, plans, and schedules.
- Facilitated the implementation and administer clerical policies and procedures for the team.
- Coordinated quality control and recommended changes to work methods or technology to improve quality, service, and increase productivity.
- Assisted in communication of issues across team.
- Work well within a team.
- Participate in quality assurance processes/programs/initiatives as requested.
ADMINISTRATIVE ASSISTANT - EVENTS CHICK - Savage, MD 20763
(2008)
ADMINISTRATIVE ASSISTANT - LAW OFFICES OF ALEXANDER & ASSOCIATES - Washington, DC 20002
(2006 - 2008)
