Biller/ Collector in Medicaid, Speaks Spanish fluently

REYES MONTALVO

Erin Ct, Loveland, OH ***** • Home: 630-***-**** • Cell: 630-***-**** • *****.********@*****.***

Skills

Skill Profile:Knowledge of ICD-9, CPTKnowledge and use of medical terminology

Familiar with Microsoft Office, Power Point and ExcelAbility to think independently

Handles responsibility successfully

Fluent in Spanish

Work History

Medicaid Biller and Collector, 12/2011 to 12/2012Community Hospital – Community Hospital, Munster, IN (Contract employee thru Addison Search)

Hired to assist the hospital with billing that consist of rejected and old accounts, assisted in lowering hospital'sAR.Billed and followed (electronically)up with Illinois Medicaid via E-care.Submitted medical bills to district offices to obtain 2432 for billing.Sent information to outside agency to apply for medical assistance for out-of-state patients. Handle all denied accounts and work with Utilization Management to assist in appealed issues. Applied the correct contractual to show the payment that was due on services rendered.

Reimbursement Consultant/Medicaid, 10/2008 to 03/2010NEBO/Passport Health Communications – Oak Brook, Ill

Documented and communicated to the client on any current or upcoming changes in payer claims processing.Responsible for feedback to the client on issues of the ATB/Worklist.Communicated with the payers when billing questions arise, or unusual rejections occur for possibleoverrides.Any new information from the payer will be relayed to the client.Ran error reports in E-Care CMS daily after import and corrected claims based on payer compliance andspecifications. Compiled financial reports pertaining to cash receipts, expenditures and profit and loss.

Medicaid Lead (Billing and Collections), 10/2002 to 10/2008MacNeal Health Network/Vanguard – Berwyn, Ill.

Lead biller and representative for Medicaid, supporting billers and representatives with account issues.Supervised billing and collections, team of nine. Assisted in the training and development of the Medicaidbillers and representatives. Billed Medicare crossover for Medicaid. Responsible for following up with the crossover accounts.Billed Medicaid as secondary payer, Medicare being primary.Responsible for adding Medicare crossover accounts to MBD (Medicare Bad Debt). Balanced the log monthlyfor corporate review.

Medicaid Representative, 01/1999 to 10/2002MacNeal Health Network/Vanguard – Berwyn, Ill.

Reviewed billed accounts to Medicaid for timely payments or rejections.Reviewed rejected accounts via THIN/NDAS, corrected and rebilled.Responsible for identifying proper payments from Medicaid and made necessary adjustment (s)to the balance.Reviewed CIMRO accounts for status and processing.

Education

Associate of Science: Dec. 2012Colorado Technical University - Colorado Springs, CO