Medical Biller
Resume:
Zoila C. Lopez
Medical Billing Specialists
*********@*****.***
Professional Profile
Detail-oriented experienced Billing specialist with eight years in the medical field and healthcare environment, demonstrating strong clerical skills and noteworthy medical coding knowledge. Proven track record of submitting accurate claims in a timely manner. Work professionally to provide exceptional customer relation.
Skills Summary
§Ability to multi-task
§Claims Processing
§Medicare/ Medicaid/HMO/ Commercial billing
§Strong communication skills
§EOB breakdown & HIFA 1500 form
§OSHA and HIPPA training
§ICD-9, ICD-10, CPT & HCPCS
§MS Office Programs
§Data Entry
§Medisoft/ Claimgear/ Brightree/ Noble House/ Autobilling
§Medical Front Office Procedures
§Medicare/Medicaid & Third Party Insurance Verification
Languages: English, Spanish (fluent)
Education
Everest University Pompano Beach, FL 07/2011
Diploma in Medical Insurance Billing and Coding
Employment History
Shiel Medical Laboratory
From November 2015 to present
Medical Billing (Nursing Home and Professional Practice)
Medicare HMO and Commercial Insurance Denial
Reviewed, revised, researched reasons for denials
Coordinated the list of denials and reports in a timely manner.
Corrected high volumes of denials and resubmission
Insurance verification
Coding interpretation from ICD-9 to ICD-10
Global Healthcare Management/AAMS
From April 2012 to October 2015
Medical Billing (DME)
Responsible for maintaining designated percentage of collections as defined by the department manager.
Conducted payment follow-ups activities on outstanding patient and insurance accounts.
Responsible for collecting outstanding receivables from insurance companies.
Reviewed, revised, re-processed and followed-up on all denials identifying uncollectible accounts and acquires approval for bad-debt write/off.
Performed excellent working knowledge of insurance carriers’ payment regulations including various reimbursement schemes, coinsurance and deductibles, contractual adjustments and managed care and commercial insurances.
Worked with payers to determine reasons for denials. Corrected and reprocessed claims for payment in a timely manner via mails, faxes or emails all appropriate collections correspondence.
Account Receivables Management, Miramar, Fl
05/2010-03/2012
Medical Billing
Provided rigorous follow-up to ensure proper payments.
Responsible for the denials report.
Created spreadsheets, in order to prioritize denials that impact the company's bottom line.
United Healthcare/Convergys Corp, Tamarac, FL 07/2008-04/2010
Customer Service
§Assisted providers and members with billing and claims questions
§Helped providers and members with health plans and benefits issues
§Meet daily goals
Wachovia Bank, Miami, FL 10/1994-04/2005
Sales and Service representative
§Combined excellent customer service with marketing
§Offered best bank products for customers needs
§Awarded for outstanding achievement SSR several times
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