Customer Service Medical Collection/Billing

Cynthia Estrada

***** ******* ****** ******, ** *1342

818-***-****-Cell#

********.*******@*****.***

OBJECTIVE:

Seeking a challenging & growth opportunity in the Medical Billing/Collection position within a Medical Group, Hospital or Business Corporation. I have extensive medical healthcare background experience for over 25 years within Multi-Specialty & Medical Office environment.

SKILLS:

• Medical Terminology and Anatomy

• Appeals & Referrals

• CPT, ICD-9 & 10 and HCPCS Coding

• Analyzing & Interpreting Explanation of Benefits

• HIPAA Regulations & Guidelines

• Knowledge of Health Insurance plans & programs

• HMO.PPO,EPO,POS,Managed Care, Medicare, & Medi-cal programs

• Insurance Verification

• Contracts

• Payment Posting & Monitors Denials

• Research Analysis

• Submission & Follow-up of Claims

• Electronic File Management

• Appointment Scheduling

• Processing of CMS-1500 & UB -04 claim forms

• Patient Customer Relations

• Excellent Interpersonal Skills

• Strong Ability to multi-task & Navigating multiple screens

• Excellent verbal & written communication skills

• Data Entry & 10 key by touch

• Typing 40 WPM

• Self-Starter & Adapt to a fast paced & changing environment

Employment Experience:

Advanced Dermatology-Linage Valencia, Ca 08/15-PRESENT

Billing/Collections

Insurance eligibility & benefits verification

Post charges and enter demographics

Reconcile claims/accounts to complete resolution

Handle of incoming customer service calls

Payment posting from both insurance & patients

Monitors Denials & re-submission of claims

A/R for all Insurance & Government

Pathology Billing

IPC Hospitalist Co., No. Hollywood, CA. 12/2014-06/2015

Insurance Benefits Verification/Collections

Responsible for BC/BS- All Regions A/R

Insurance Processing/Follow-up Claims Correspondence

Obtain Current & Retro Authorizations with Pre-Determination

Verify Eligibility & Benefits with Coverage

Re-billing/Appeals

Contact doctor office & Hospital

Customer Service in/out bound

Obtained Medical Records from Doctors

Experience in Medical Policy & Utilizing insurance Benefits

Dr.Balbir Singh M.D./Nephrology & Internal Van Nuys, CA. 08/2014-10/2014

Insurance Benefits Verification/Billing

Insurance Processing/Follow-up & Correspondence

Prepare Billing for all Dialysis: input demographics, charges,

From Hosp.: Mission Community, Valley Pres., & Northridge

Customer Service In/Out bound

Verify eligibility & benefits

Obtained Authorizations

Medtronic Minimed Inc., Northridge, CA 01/2005-8/2012

Collections-PFS-High Risk

Audit accounts receivable aging

Reconciled aged underpaid claims

Re-billing/Prepared appeals

Follow-up Claims & Correspondence

Obtained current & retro authorizations or referrals

Verification Eligibility & Benefits

Insurance Contracts

Worked on projects with Supervisor or Team Lead

Contacted insurance companies-via website navigation or call

Prepared refunds and reviewed credit accounts

Ability to prioritize work in consideration of deadlines

Focus & attention to detail in resolving issues

Professional customer service that interact with internal & external customers

History Previous Positions:

Anesthesiologists Assoc. Inc., Tarzana, Ca

Billing/Collections

Valley Healthcare Medical Group Burbank, CA

Billing/Collections

Unilab Tarzana, CA

Billing/Collections

Preferred Health Medical Woodland Hills, CA

Worker’s Comp/Collections-Liaison

Keystone Medical Group Chatsworth, CA

Billing/Collections

Greater Valley Medical Group Granada Hills, CA

Collection Specialist

Mammography & Ultrasound Center Burbank, CA

Billing/Collections Supervisor

Stat Lab-Holy Cross Hospital Mission Hills, CA

Billing/Collections

Granada Hills Pharmacy Granada Hills, CA

Convalescent Medical Supplies & Pharmacy

Medical Clerk/Billing

EDUCATION: Everest College-Medical Insurance Billing/Coding Reseda, CA. Graduate 08/2014-Diploma

Certificate: HIPPAA & OSHA-(current)

Software: SAP, GE Centricity, IDX, Office Ally & Inet-Portal

Computer Skills: MS office (Word, Excel, Outlook) and website navigation

Reference upon request:

Contact this candidate