Medical Insurance
Resume:
Julie Villegas
Los Angeles, CA ***32
OBJECTIVE
To gain a position in a Healthcare company where my collections experience and strong communication skills wil be fully utilized in a challenging and rewarding environment.
SKILLS
Bilingual Spanish Medical Biller/Collector with over 12 years of experience
Experience collecting and billing on Medicare, Medi-Cal, HMO’s, PPO’s and IPA
Skilled in the recovery of aged AR; up to 6 Mos.
Ability to multi- task, solid judgement and decision making
Strong writing skills; write denial/appeal letters
MS Word, Excel, CPSI, IMACS and Carecloud
PROFESSIONAL EXPERIENCE
Acuity Eye Group ( MEDsearch Completed Assignment ) Pasadena, CA Medical Biller and Collections 12/2017 – 5/2018
Collections of monies from payers on Ophthalmic Physician accounts
Responsible for all aspects of follow up and collections of aged AR, including making telephone calls and accessing payer website
Research, appeal, and resolve claim rejections, underpayments, and denials with
appropriate insurance payor. Reviewed EOB and EOR
Worked with commercial, Managed Care, HMO, Workers comp and Government payors
Collection Consultants of California Glendale, CA
Collector 09/2012 – 01/2017
Collections for medical physicians and hospitals for ER services
Responsible for third party liability, workers compensation claims and appeals.
Contacted insurance companies to check on status of claims payments and write appeal letters for denied claims
Billed and rebilled insurances claims for Blue Cross, Blue Shield, Tri-care, HMO and PPO.
Contacted consumer for payment or establish payment plan based on customers' financial situations.
Ensured compliance with all federal, state, local laws regulatory agencies familiar with FDCPA
Followed up on an average of 100 + aged A/R accounts daily
AHMC ( Accountemps-Completed Assignment) Alhambra, CA
EOB Reviewer/Collector 04/2010 - 9/2012
Reviewed all EOB’s to ensure claims were paid correctly per contract and forward EOB’s to correct departments.
Located and attached appropriate files to incoming correspondence requiring replies
Followed up with insurance companies; Medi-Cal, HMO’S, PPO’ and IPA’s via internet or thru telephone regarding billed claims and collections
Contacted an average of 100 + aged A/R accounts past due 90 + up to 6 months
Utilized excel to follow up on accounts and documented
Toggled between various application databse utilizing computer systems; CPSI and IMACS.
Performed bookkeeping duties, such as credits or collections, preparing and sending financial statements or bills, and keeping financial records.
Sorted and filed correspondence and performed miscellaneous clerical duties
Corresponded and wrote appeals
Recorded information about financial status of patients and status of collection efforts.
Advised consumers of necessary actions and strategies for accounts.
United States Collection Bureau Los Angeles, CA
Collector 1/2008 – 12/2009
Collections for medical physicians and hospitals for ER services
Followed up an average of 30 + aged A/R accounts for Medi-Cal payor
Contacted self -pay patients resolve delinquent accounts
Contacted patients for payment or establish payment plan based on consumers financial situations
Answered customer questions regarding problems with their accounts.
Recorded information about financial status of customers and status of collection efforts
Contacted insurance companies to check on status of claims payments and write
appeal letters for denial on claims such as Blue Cross, Blue Shield, HMO, PPO, Tri-care.
Skipped tracing and automatic dialer
Ensured compliance with Federal, State, Local laws familiar with FDCPA
All Care Medical Group Huntington Park, CA
Medical Collector/Biller 06/2007 – 11/2008
Answered inquires vial telephone regarding past due accounts from English and Spanish speaking patients.
Conducted follow up on delinquent accounts (patient billing) and reconciled any payment discrepancies.
Communicate frequently with insurance companies to determine action needed
and to ensure claim is processed and payment received on outstanding claims.
Filed appropriate appeals on denied claims and track status of appeals through resolution
Exercised independent judgment with conducting resolutions to patient issues and concerns.
Operated office equipment, such as fax machines, copiers, or phone systems.
Answered telephones and give information to callers, take messages, or transfer calls to appropriate individuals.
Located and attached appropriate files to incoming correspondence requiring replies.
Kaiser Permanente Pasadena, CA
Medical Collector/Special Recovery Dept. (Temp position) 12/2006 - 03/2007
Collection on personal injury account for 3rd party claims
Collection Consultants of California Glendale, CA
Collector 03/2004 – 04/2006
Collections for medical physicians and hospitals for ER services
Responsible for third party liability, workers compensation claims and appeals.
Contacted insurance companies to check on status of claims payments and write appeal letters for denial on claims
Billed and rebilled insurances claims for Blue Cross, Blue Shield, Tri-care, HMO and PPO.
Contacted consumer for payment or establish payment plan based on customers' financial situations.
Ensured compliance with all federal, state, local laws regulatory agencies familiar with FDCPA
Followed up on an average of 100 + aged A/R accounts daily
EDUCATION
Woodrow Wilson Senior High School, Los Angeles, CA Diploma 6/1986
Contact this candidate