Professional Profile

Career Objective

Seeking an opportunity in the Medical Field, where I can utilize my 10+ years skills and demonstrate my knowledge.

Skills:

Speak, write and read English and Spanish fluently.

Billing and coding skills, electronic claim submission, claim follow up, electronic and regular payment posting.

Insurance knowledge, Ex: PPO, HMO, and POS insurances, as well with Medicaid and Medicare programs.

Fast learner and able to grasp easily new changes in the medical billing and coding field.

Good customer-relations background

Very organized and able to meet deadlines.

Clear knowledge on reading and explaining EOB’s

I can work Independently and always follow company protocols.

I have a very good understanding of Hipaa and privacy act to maintain patients’ confidentiality.

Familiar with Healthcare industry rules to include False claims act, fair debt collections act and Stark Law.

Responsibilities:

Keep updated to understand most if not all Insurance plans to be able to bill correctly according to plan guidelines and by applying payer policy.

I Submit Electronic Claims according to plan guidelines.

I Follow up on claim denials, corrected claims and written appeals to avoid time deadlines and loss of revenue.

I provide education to staff and leadership and make recommendations to minimize delays in revenue.

I can use good judgment and critical thinking skills to identify and resolve issues.

I Work the AR report ongoing to save outstanding accounts.

I work with CPT ICD-10 and HCPC Coding regulations and always stay updated.

Multitask, Excellent computer skills, very familiar with EHR, and able to learn new programs rapidly.

I engage in staff and billing meetings to review work and keep everyone updated on error trends, and new information.

Work History

UIW Rosenberg school of Optometry

2013 ~ current

Senior billing and coding Specialist

Education

High School Diploma

Career Point College

Clinical Office Management with billing and coding skills.

References:

Priscylla Galvez: 210-***-****

Homer Martinez: 210-***-****

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