Ernestine M. Leach Medical Claims Biller + Processor

**** ****** ***. **** * • Whittier, CA 90602

acvto0@r.postjobfree.com

Professional Summary:

Experience of 10 years in my professional field. Positive attitude, analytical researcher, hardworking and self-motivated Medical Claims biller/processor available to offer professionalism, thoroughness and adapt well as a team player to a medical organization in need.

WORK EXPERIENCE

Medical Claims Processor Correspondence letters

Kaiser Permanente California Claims Administration Downey, CA 2015-Present

Comfortable processing denial correspondence letters for DME, SNF, Home health providers.

Knowledge UB-04 And HCFA 1500.

Expert utilizing-!File, !Query, MAINFRAME-AOMS, DOTS, and Lotus notes programs.

Run daily department reports for claim denial provider correspondence letters.

Accurately verify claim rejects and enter new claims in KE and KFI programs for internal claims dept.

Claims Processing keying electronically.

Knowledge of medical terminology and ICD10.

Primary Caretaker

Home Whittier, CA 2014-2015

Primary caretaker for my two children

Medical Biller + Collector + Processor

Elite Home Medical & Respiratory Anaheim, CA 2009-2014

Processed 50-60 DME claims a day according to compliance guidelines along with multitasking a time management work flow.

Expert utilizing Pacwin, Brightree, and Outlook programs.

Brought in successful revenue of over 20,000 a day collecting from patients and providers.

Maintained a steady workflow collecting medical records for compliant documentation for Medicare and other private insurance.

Accurate Insurance verification for patient coverage for commercial, Medicare, and Medi-cal.

Sincere customer service phone etiquette with patients, and insurance providers.

Perform as an expert with prompt follow up and processing denied claims. Audit claims with thorough research for compliant documentation.

Proper follow up on appeals for Medicare and other private insurances.

Efficient posting payments to patient accounts, Medicare, and other private ins.

Knowledge of Coding-ICD-9and CPT

Medicare and MediCal Grevience and appeals process and follow up.

Benefit analyst

American Medical Response Torrance, CA 2008 – 2009

Managed accounts for new and existing patients in verifying current insurance coverage for billing.

Dedicated myself with long hour days contributing revenue of over 10 million.

Claims Billing Processor + Documentation researcher

Discount Drugmart Inc. Medina, OH 2006-2008

Expert utilizing Dezine, and AS400 programs for billing DME claims electronically and paper.

Maintained prompt pre authorization requests for new and renewed authorizations For Medicaid/Medi-Cal insurance.

Contributed assisting clean claims and efficient follow up on patient accounts bringing in revenue of over 650 million.

Sincere customer service assisting patients in resolving questions and concerns along with patient responsibility.

Thorough research with attention to detail collecting medical documentation.

Knowledge of Coding-ICD9 and CPT.

Examined with accuracy correcting pre-edit reports for billing process.

EDUCATION

Whittier High School Whittier, CA General education

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