Ashley Houston
Hanford
Summary
Proven Billing Specialist with a track record of enhancing revenue potential and resolving complex billing discrepancies at Wilshire Business Partners. Expert in insurance verification and customer service, adept at improving system accuracy and maximizing reimbursement. Skilled in fostering teamwork and efficiently managing patient accounts, ensuring compliance and high satisfaction levels.
Overview
6
6
years of professional experience
Work History
Billing Specialist
Wilshire Business Partners
02.2022 - Current
- Researched and resolved billing discrepancies to enable accurate billing.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
- Maximized revenue potential by identifying and resolving under-billed accounts.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Identified and resolved patient billing and payment issues.
- Insured smooth sailing of the revenue cycle from start to finish by verifying insurance coverage, requesting authorization for the services needed, billing claims timely, and following up on any unpaid/underpaid services, as well as posting all payments, and processing all true refund requests.
Medical Billing Specialist
Central California Faculty Medical Group
02.2019 - 06.2021
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Located errors and promptly refiled rejected claims.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Identified and resolved patient billing and payment issues.
- Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
- Liaised between patients, insurance companies, and billing office.
Education
Certificate of Technical Studies - Medical Billing And Coding
San Joaquin Valley College
Hanford, CA06-2013
High School Diploma -
Lemoore High School
Lemoore06-2007
Skills
- Billing systems and software
- Insurance verification
- Invoice processing
- Customer service
- Claims processing
- Data entry proficiency
- HIPAA compliance
- Denial management
- Payment posting
- Month-end closing procedures
Timeline
Billing Specialist
Wilshire Business Partners
02.2022 - Current
Medical Billing Specialist
Central California Faculty Medical Group
02.2019 - 06.2021
Certificate of Technical Studies - Medical Billing And Coding
San Joaquin Valley College
High School Diploma -
Lemoore High School
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