Dalia Fuerte

**** ******** **

Lewisville, TX ***67

972-***-****

ac5jsc@r.postjobfree.com

SUMMARY OF QUALIFICATIONS:

Proven ability to identify problems, establish solutions with follow-through in the revenue cycle.

Insurance Verification, admissions and Data Entry.

Experienced in Billing and Collections for both payers and providers.

Experienced in handling complex escalated provider concerns.

Knowledgeable with HCPC, UB 94 and HCFA 1500.

In depth knowledge of reimbursement policies, stop pay for commercial accounts.

Handle account receivables in a timely manner with a 2 day TAT.

CITRIX, CUBS, Ontario, EPIC, STAR, Metrics, Meditech, Inservio and Advancemd.

Word, Excel, Power Point, Access and Outlook & Outlook Express.

PROFESSIONAL EXPERIENCE:

1/2014- Present 1/2016 Forest Park Medical Center Southlake

Hospital Insurance Verification Represenative /Admissions Clerk

Responsible for maintaining on time payments from insurance carriers.

Balanced monthly statements to reflect all changes from patients and insurance.

Patient Access/Admitting patients.

Coordinate payment plans with patients.

2/2013-5/2013 Cymetrix Inc.c/o Aerotek

Hospital Claims Representative – Patients Financial Accounts

Responsible for maintaining on time payments from insurance carriers.

Ensured company was in compliance with all billing formats.

Balanced monthly statements to reflect all changes from patients and insurance.

Coordinate payment plans with patients.

8/2010-3/2011 Consulting Dermatologic Specialists

Insurance Representative

Analyze and research statements.

Resolve patient and payer accounts.

Respond to inquiries from patients regarding EOR's and EOB's.

Resolve appeal underpayments not made according to contract fee schedule.

1/2008-9/2009 Medical & Surgical Clinic of Irving

Office Billing Manager

Identified billing and coding trend errors for resolution.

Insured that both electronic and paper claims went out timely.

Met with physicians regularly to discuss billing, coding and reimbursement.

Informed physicians and staff of payer changes regarding documentation, coding and reimbursement.

Investigate and respond to all correspondence and request from insurance carriers and patients.

7/2007-12/2008 Dr. Ramon Cruz

Office Billing and Insurance Verification Representative

Claims follow-up for insured patient accounts.

Identified billing and coding trend errors for resolution.

Verified patient eligibility with insurance carriers, Medicare and Medicaid.

Handle pre-authorizations, appeals and set up payment plans.

7/2005-12/2007 Presbyterian of Denton

Admissions Registration Coordinator

Verified patient eligibility with insurance carriers, Medicare and Medicaid.

Handle pre-authorizations before patients schedule visit.

EDUCATION:

1991 – 1993 Court Reporting Institute of Dallas, Dallas, TX

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