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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing and collections, including knowledge of ICD-10, CPT, and HCPCS coding, as well as proficiency in managing claims and patient information systems. Maintains compliance with insurance guidelines and prioritizes timely filing and documentation.
Highest-signal resume keywords
Medical Collections/Billing ExperienceICD-10, CPT, HCPCS KnowledgeBilling Claim Forms (UB04/1500)Patient Accounting Systems (EPIC, Cerner, etc.)Microsoft Word and Excel Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical BillingClaims ResearchEligibility VerificationInsurance Information ManagementEOB AnalysisClaim Payment SecuringTimely Filing ComplianceMedical Documentation HandlingData EntryThird Party Billing Guidelines
Soft Skills
Attention to DetailCommunication SkillsProblem-Solving SkillsConfidentiality MaintenanceOrganizational Skills
Tools & Technologies
Health Information SystemsEMRClaim ScrubbersPatient Accounting SystemsDDE Medicare Claim System
Industry Keywords
Payer WebsitesClaim Status MonitoringAuthorization ProtocolsInsurance Collection GuidelinesGovernment Rules and Regulations
Tech Stack
Tools & technologiesInvision
About the role
Key responsibilities & impact- Verify or obtain eligibility and/or authorization using payer websites, client eligibility systems, or phone
- Update patient demographics and insurance information in appropriate systems
- Research and status unpaid or denied claims
- Monitor claims for missing information, authorization, and control numbers (ICN/DCN)
- Research EOBs for payments or adjustments to resolve claims
- Contact payers by phone or written correspondence to secure claim payments
- Access client systems for payment, patient, claim, and data information
- Follow guidelines for prioritization, timely filing deadlines, and notation protocols
- Secure medical documentation required or requested by third-party insurance carriers
- Maintain confidentiality of patient information in accordance with insurance collection guidelines and corporate policy
- Perform other related duties as required
Requirements
What you’ll need- 1-2 years of medical collections/billing experience
- Basic knowledge of ICD-10, CPT, HCPCS and NCCI
- Basic knowledge of third party billing guidelines
- Basic knowledge of billing claim forms (UB04/1500)
- Basic knowledge of payor contracts
- Working knowledge of Microsoft Word and Excel
- Basic working knowledge of health information systems (e.g. EMR, Claim Scrubbers, Patient Accounting Systems)
- Preferred: Working knowledge of one or more patient accounting systems: EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon
- Preferred: Working knowledge of DDE Medicare claim system
- Preferred: Knowledge of government rules and regulations
