Reimbursement Specialist Resume Guide

Proficient reimbursement specialist with 5+ years of experience in medical claims processing, auditing, and cost containment. Seeking to join ABC Health Care as a Reimbursement Specialist where I can utilize my knowledge of coding regulations and reimbursement systems to ensure accurate payments for clients. At XYZ Medical Group, identified potential savings opportunities by assessing billing data which resulted in an estimated 10% reduction in the total costs.

Diligent reimbursement specialist with 8+ years of experience in healthcare finance. Adept at understanding complex regulations and policies related to reimbursements, coding, and billing processes. Skilled communicator who works well with coworkers and clients of various backgrounds. Seeking a position as a reimbursement specialist at ABC Healthcare to help streamline financial operations while ensuring compliance with applicable laws and regulations.

Well-rounded Reimbursement Specialist with 6+ years of experience in medical billing and coding. Experienced in working with insurance companies to ensure proper reimbursement for medical services rendered. At XYZ, successfully reduced payment backlog by 30% within first 3 months on the job, saving an estimated $250k per year. Proven ability to effectively interpret complex policy regulations for accurately processing claims payments.

Professional reimbursement specialist with 4+ years of experience in a fast-paced medical office setting. Seeking to utilize expertise and knowledge of insurance policies, claim processing rules, and regulations to support the reimbursement needs at ABC Medical Center. At XYZ Clinic, managed the submission process for over 500 claims per month resulting in an average turn-around time reduction by 15%.

Hard-working and detail-oriented reimbursement specialist with 5+ years of experience. Expert in medical coding and billing, including CPT, ICD-10, HCPCS. At XYZ Hospital handled insurance claims for over 400 patients per month while keeping errors below the national average. Experienced in dealing with Medicaid/Medicare regulations to ensure timely reimbursements and compliance with government laws.

Driven reimbursement specialist with 5+ years of experience in healthcare billing and coding. Demonstrated track record of successfully optimizing reimbursements for a wide range of clients, resulting in improved cash flow for the organization. Seeking to join ABC Healthcare as a Reimbursement Specialist where I can leverage my knowledge and expertise to ensure timely payments while reducing costs.

Accomplished reimbursement specialist with 5+ years of experience in the healthcare industry. Skilled at auditing and researching medical claims, preparing financial reports, creating reimbursement worksheets to ensure accuracy of payments, and handling denials from insurance companies. Received multiple awards for 100% accuracy rate on all reimbursements processed while working at XYZ Hospital.

Detail-oriented reimbursement specialist with 5+ years of experience in a healthcare setting. Expertise in providing effective guidance for medical billing and coding, resolving payment denials, reconciling accounts receivable, and managing patient data. Looking to join ABC Medical Group as the new Reimbursement Specialist to ensure accuracy of reimbursements from insurance companies.

• Updated and maintained internal reimbursement databases, ensuring that all entries were accurate and up-to-date; improved data accuracy by 15%.
• Structured and processed 300+ employee reimbursement requests per month, verifying information for accuracy before payment was issued.
• Compiled detailed financial reports on a weekly basis to track reimbursements against budgeted expenditure, identifying any discrepancies of $1,000 or more; reduced overdue payments from 7 days to 2 days on average.
• Reconciled accounts with auditors quarterly in order to validate the authenticity of expense claims; identified overcharges totaling $10K which resulted in cost savings for the company.
• Thoroughly reviewed each request according to IRS regulations prior to issuing payments, maintaining compliance at all times and avoiding potential penalties or fees associated with noncompliance cases.

• Streamlined reimbursement processes for over 150 medical claims a day, resulting in an improved turnaround time of 2 days and increased efficiency by 20%.
• Developed new procedures to verify insurance information for incoming claim requests; reduced the number of errors made when processing payments by 25%.
• Improved accuracy rates from 70% to 99% on all processed reimbursement forms, ensuring timely payment was received within 1 week or less.
• Investigated discrepancies with patient records, verifying supporting documents such as doctor notes & bills before approving reimbursements; identified $5,000 worth of fraudulent activities and successfully recovered it back into company accounts last year.
• Proficiently managed online databases to track every stage in the reimbursement process: generated reports identifying any issues that delayed payments and resolved them quickly within 24 hours on average.

• Revised and audited over 500 reimbursement claims from healthcare providers, resulting in a 15% increase in accuracy and reducing errors by 10%.
• Processed up to 200 reimbursement requests daily within 24 hours; consistently maintained an average of 98% accuracy rate for all transactions.
• Meticulously reviewed patient records, insurance forms and health plan policies to ensure all data was accurate before submitting payments for approval.
• Participated in regular meetings with the accounting/finance department to discuss process improvements; implemented new procedures that improved turnaround time by 20%.
• Demonstrated expertise on medical coding systems (CPT & ICD-9) when assessing patient documentation prior to making payment reimbursements; reduced mispayment occurrences by 35%.

• Spearheaded the completion of over 300 reimbursement claims for healthcare services, resulting in a 17% decrease in processing time.
• Calculated and verified the accuracy of medical bills to ensure that all reimbursements were correct; identified and corrected any discrepancies before submitting claims.
• Tracked payment status on submitted claims using various software programs, following up with insurance companies as needed to make sure payments are received promptly; recovered over $20K in unpaid reimbursements last year.
• Resolved customer inquiries relating to claim denials or requests for additional information within 24 hours while upholding high standards of patient confidentiality at all times.
• Diligently maintained an organized filing system consisting of paper/electronic documents containing detailed records related to reimbursement cases handled during each fiscal quarter period.

• Expedited the reimbursement process for over 500+ medical and insurance claims, reducing paperwork turnaround time by 25%.
• Introduced a digital filing system which reduced errors in processing invoices by 33%, resulting in $7000 saved annually on administrative costs.
• Formulated comprehensive best practices to streamline the claim submission procedure, increasing accuracy of reimbursements paid out by 45%.
• Documented all financial transactions according to company policies and procedures; successfully identified fraudulent activities within the accounts department before they occurred.
• Consistently achieved 97% accuracy rate when verifying patient information against relevant databases, saving 3 hours per week on manual checks alone.

• Utilized advanced accounting principles to process over 300 reimbursement claims per day, ensuring accurate reimbursements and compliance with applicable laws and regulations.
• Facilitated the resolution of complex cases by interpreting policy documents, conducting in-depth analysis of documentation & data reconciliation; decreased processing backlogs by 30%.
• Represented the organization at external meetings/conferences related to financial policies & procedures as well as payment processes/procedures; successfully addressed customer concerns within 24 hours on average.
• Prepared periodic reports highlighting discrepancies or irregularities in claims submitted for reimbursement while proactively providing problem solving suggestions that improved accuracy rates from 75% to 95%.
• Competently handled a wide range of administrative duties such as verifying authorization forms, updating financial records and responding promptly to inquiries from clients within 48 hours or less.

• Mentored and trained 8 new reimbursement specialists in billing and coding processes, resulting in a 30% increase in efficient processing time.
• Audited over 5,000 medical claims to ensure they were correctly coded before submission for payment; identified incorrect submissions and corrected them with minimal expense or delay.
• Monitored the reimbursements of up to 500 clients on a monthly basis and managed follow-up actions for any discrepancies found; achieved an overall accuracy rate of 95%.
• Achieved full compliance with all government regulations governing healthcare payments by staying abreast of changes in laws, policies & procedures concerning reimbursement practices.
• Substantially reduced rejections from insurance providers due to improper coding or filing errors by utilizing sophisticated software tools used for accurate claim validation & submission cycles.

• Submitted over 500 reimbursement claims a month for medical, dental and other expenses; accurately tracked claim statuses to ensure timely payments to clients.
• Approved an average of 95% of daily submitted claims within 24 hours; saved the company over $200,000 in unnecessary payment delays by streamlining processes.
• Reliably processed high volumes of paperwork with 100% accuracy while adhering to all internal policies and government regulations regarding filing procedures & deadlines.
• Reviewed discrepancies between invoices and insurance documents every day; identified errors quickly leading to reduced rejections/denials rate by 15%.

Bachelor of Science in Accounting
Educational Institution XYZ
Nov 2011

Certified Reimbursement Specialist
American Medical Billing Association
May 2017