Medical Billing
Resume:
Donie Salazar
Cambridge, MD **613
*************@*****.***
OBJECTIVE
Motivated medical billing/denial specialist in hospital, physician and durable medical equipment (DME). Highly skilled insurance collector with experience in denial management, commercial and government insurance claims. Able to analyze and validate patient information, diagnoses, and billing data for claim denials. Demonstrated leadership skills that enable the processing of high volumes of denial claims information to achieve revenue generation goals. Excellent follow up skills to complete denied claims into paid claims.
CORE QUALIFICATIONS
●Medical Denials
●Medical Billing
●Operations Management
●Quality Assurance
●Patient Confidentiality
●Excellent hands on experience with management/customer service communication skills.
●Dedicated work ethic and strong people skills.
●Follow up Skills
●Appeal Knowledge
During the period of January 2002 through current, I have worked contract either directly with a hospital on a special project or through temporary agencies doing medical/executive administrative work. Currently looking for permanent, temporary or remote positions in the medical billing/collections field.
PROFESSIONAL EXPERIENCE
Patient Accounts Representative August 2017 – June 2017
Peninsula Regional Medical Center Salisbury, MD
●Collected $50 Million of unpaid claims during a 10 month period working on a 4 person team for STAR Run-out Project.
●Worked in Float Core doing medical denials for Commercial, Secondary and Government insurances.
●Called insurance companies for status on claims and to gather denied information to submit documentation for approval of claims.
●Called authorization departments or companies to find authorizations to resubmit to insurance companies to approve payment of claims.
●Sent appeal letters with documentation to insurance companies.
●Worked on monthly Aged Trial Balance (ATB) spreadsheets.
●Worked on PIP and Workman’s Comp denials.
●Worked on TRICARE, VA Choice, VA Administration, BC/BS, Priority Partners, Aetna and other insurance companies.
●Resubmitted corrected claims and documents (medical records and Itemized Bill (I/B) to insurance companies for payments on denied claims.
●Faxed W-9 forms to government agencies and insurance companies.
●Follow up on past due and delinquent accounts to reduce number of outstanding balances.
●Uphold and reinforce compliance with hospital policies and federal regulations such as HIPAA.
●Submitted notes in STAR of updated information on each claim.
●Google DX, CPT and HCPCS codes.
Medical Biller May 2010 – November 2010
United Medical Center Washington, DC
●Accurately input procedure and diagnosis codes into billing software to generate invoices.
●Used electronic charge capture practices such as billing system and medical billing clearinghouse accounts to submit invoices on time.
●Follow up on past due invoices and delinquent accounts to reduce number of unpaid and outstanding balances.
Physician Medical Biller November 2009 – May 2010
Washington Hospital Center Hyattsville, MD
●Input invoice information into billing software and clearinghouse accounts to generate invoices.
●Called insurance companies for follow up on delinquent or denied claims.
●Gathered documentation to resubmit to insurance companies for payment of invoices.
Medical Collections Clerk April, 2009 - November, 2009
The Anesthesia Billing Company Annapolis, MD
●Called hospitals and doctor’s offices to collection information for medical claims.
●Called patients for collections purposes.
●Worked off of delinquent accounts Excel spreadsheet.
Intake/Insurance Supervisor January, 2004 - May, 2005
State of Maryland, Open Doors Annapolis, MD
●Supervised one employee
●Conducted intake interiews for incoming patients
●Discussed payment options i.e. sliding scale, insurance
●Billed and Coded medical claims
●Corrected denial claims
●Submitted claims for payment
DME Claims Biller February, 2002 - February, 2003
MedStar Health Hanover, MD
●Processed DME Claims
●Called insurance companies, patients, doctor’s offices for claims information.
DME Claims Biller February, 2003 - June, 2003
MediRent & Sales Dundalk, MD
●Processed DME claims
COMPUTER SKILLS
Microsoft Programs – Word, Excel, PowerPoint, Access and Outlook.
Database and Medical Programs – SAP, MS Act, MS Visio, CostPoint, Design6, Meditech, Signature, AZYXXI, Epremis, STAR
EDUCATION
Western International College Phoenix, AZ
Bachelor of Science in International Business May, 2004
Anne Arundel Community College Arnold, MD
Courses in Medical Billing and Coding, 2002 – 2003
Medical Terminology, Pharmacology
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