Insurance Microsoft Office

Detail oriented quality focused Patient Account Representative Specialist in Billing and Collection for all insurance types with over 24 years of experience. Understand the importance of timely filing and collection practices in order to receive fast reimbursement. Highly experienced when it comes to auditing and receiving accounts to reconcile the balance. Very organized, highly motivated, detail-directed problem solver, fast and independent worker. Have strong work ethic and integrity when it comes to billing and collection. Able to handle high volume of calls in order to meet maximum productivity and monthly goals while recovering payments on delinquent accounts.

Technical Skills & Abilities

• Claim Entry and Payment Posting

• PPO, HMO, Managed Care, Medicare, Medi-Cal

• Insurance and Patient Aging Appeals

• AME/QME Med Legal

• HIPAA Compliance

• Records Organization and Management

• Inpatient/ Outpatient Facility Billing

• MediTech

• Office Ally

•CAMIS

•SSI

• Microsoft Office (Word, Excel, Outlook)

• 10 key

• Workers Compensation

• CMS-1500

• EOB’S

• Insurance Verification

• Billing / Collections

Professional Experience

Vantage Oncology, Manhattan Beach, CA 08/2016 - 09/2017

Insurance Specialist for Cancer Patients

Collector for radiation oncology practices

Utilized billing system to identify delinquent accounts

Updates status of delinquent accounts until fully satisfied

Prepared billing audits for initial electronic and paper claim submission

Reviewed EOBs daily, making corrections and rebilling as necessary

Followed established departmental policies, procedures, and objectives

Worked with G4/Centricity practice management system

Navigant Cymetrix Health Services, Torrance, CA 04/2015 - 05/2016

Patient Account Representative

•Responsible with different projects from different hospitals

Most are from Providence Health Services, Managed Care, PPO and Private Insurances.

Called patients and insurances for the denials of payments and patient’s insurance coverages

Report to the supervisor regarding claims not received by insurances, and incorrect denials that needs to be done or resolve for evaluation

Special project from Providence Health & Services that included claims that are not paid, claims with no authorization, claims that are not received, claim billed with incorrect insurance, and all claims need to rebill for untimely filing

Providence Health & Services, Torrance, CA 06/1990 - 01/2015

Patient Account Representative, Del Amo Diagnostic Center

Responsible for billing and collection for Del Amo Diagnostic Center

Billed professional claim to different insurances (PPO, HMO) and manage care

Billed medical and medicare claims and billed 2nd insurance

Review denial and called insurance for rebilling

Filled untimely filing

Billed professional claims to worker’s compensation

Responsible for insurance verification, precertification, and preauthorization

Followed unpaid account and balance of patients re copay and deductible

Submitted requests of appeals for any other documents necessary to insure payments

Responsible for the mails and EOB’s for review

Entered procedure and diagnosis codes with the patient information, add modifiers verified DX

Posted deductibles, adjustments, and payments per EOB details

Researched and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts

Providing quality control on paper claims processed traces, denial, control checks, initiated appeals, and submitted letters for reconsideration

Education & Training

Certificate, Computerized Accounting

SCROC, Torrance, Ca

Certificate, Data Entry

SCROC, Torrance, Ca

Secretarial Course

Far Eastern University, Manila, Philippines

Bachelor’s Degree in Finance

Philippine Christian University, Manila, Philippines

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