Medical Billing and Reimbursement
Resume:
Lisa Vega
Medical Reimbursement & Billing Naperville, IL 60564 *************@***********.***
** ***** ******* ********** **** patient care to the reimbursement completing the account. Billing, reimbursement, insurance verification. Management experience.
Team player, great time management skills, extremely knowledgeable in medical field, willing to learn above and beyond my job.
Willing to relocate: Anywhere
Authorized to work in the US for any employer
Work Experience
Reimbursement Specialist
Byram Healthcare Centers - Downers Grove, IL June 2017 to Present
Work on 14 states of Medicaid. 76 Managed Medicaid plans. Work denied claims by researching the root cause of the denial.
Work on multiple portals, resubmit corrected claims for payment. Request Retro Authorization for Colorado Medicaid. Work on several projects to solve denial issues and reach out to the Medicaid representatives for erroneous denials and solve the issue.
Work both primary and secondary Medicaid plans. Training new employees, went from 5 employees working the plans to one person and it is handled efficiently. Clear all assigned pools within 24 hour turn around time. Continuous communication with supervisor and director on all issues. Respond to all billing liaison calls to solve incorrect patient billing. Team player, time management skills, open line of communication with Medicare collectors and any Managed insurance plans that need assistance in the Medicaid secondary denials. Software Artiva, ERP, Waystar, Availity, Illinois Medicaid portal, Noridian, Excel, Office Word, Epic, Allscripts. Followed HIPAA & Compliance guidelines.
Insurance Verification Specialist Presence Health –LaSalle Network Bolingbrook, IL September 2016 to April 2017
Worked on two computer software programs Epic & EMR, Scheduled patient appointments, Took charge of restocking all needs and help to order stock, DME supplies for patients, Took copay's, payment on accounts, Assisted Md's assistants with needs, Assisted MD's as needed, Balanced the day finances, Set up and downloaded the X-ray films from the flora scan machine, Multi task in a very fast paced environment, Completed courses to qualify for ordering of test for patients all courses a grade of 96% - 100% on grade, updated all patient demographics
Office Assistant
Sportsmed Orthopedic - Carol Stream, IL September 2015 to February 2016
In charge of running Satellite office in Naperville, Schedule patients appointments, Placed order for DME supplies, Opening and closing office, Balance drawer on patient payment. Data Entry, phone skills, assist in procedures when needed.
Administrative Assistant, Billing Coordinator
The Oasis Center for Health - Hinsdale, IL February 2015 to July 2015
Open and Closing of Office. All Administrative Duties.
Billing and Coding of Medical Claims. AR Insurance and Patient.
Month End Reports.
Insure office practices are in compliance with HIPAA regulations. Balance of payments and refunds at end of business day.
Office Manager
Thomas Rodts, MD Orthopedic Surgeon - Elmhurst, IL June 1996 to November 2001
Ran the entire practice from the patient scheduling, pre certification prior to surgery, obtained authorization for workman’s compensation claims, billing from the beginning to the payments needing posting and collection. Scheduled all surgeries at Elmhurst Hospital, scheduled patients appointments, talk to sales representative regarding all DME supplies and ordered inventory. Recredentialing of physician. Updating all insurance plans, prepared charts, updated patient files. Overlooked the entire office and receptionist needs and concerns.
Education
Certification
St. Luke's Medical Center - Chicago, IL
Certification in General
Deerbrook Nursing Center - Joliet, IL Northern Illinois University - DeKalb, IL
Skills
20 + years of healthcare experience, very diverse in my background, excellent software knowledge, insuance knowledge, passion for the healthcare field. Team player, impecible attendance, organized, fast learner. (10+ years), Medical Billing (10+ years), Medical Insurance (10+ years), Medicare (3 years), Insurance Verification (10+ years), DME (2 years), Hipaa (10+ years), Illinois Medicaid (3 years), Microsoft office (10+ years), Artiva (2 years), ERP (2 years), Epic (1 year), Availity (6 years), Waystar (2 years), Allscripts (1 year), Healthlogic (2 years)
Awards
Recognition Act of Kindness
June 2019
Help assist fellow teammates on all Medicaid questions and training of new employee.
Certifications/Licenses
CNA
August 1990 to Present
Patient Care, CPR, Medical Terminology
PCT
July 1992 to Present
Phlebotomist, Intensive Care Unit, Patient Care, Medical Terminology
Additional Information
Reimbursement, Billing & Coding Complex problem solving
Excellent judgment & decision making
Worked in MICU as a PCT in the Medical Intensive Care Unit.
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