CONTACT

Address : Long Beach, CA *****

Phone : 562-***-****

Email : ad2r3i@r.postjobfree.com

SKILLS

Experience using Medical Practice

Management Software, currently

CPR+, Paragon, Sunrise management

system

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Clearing house familiarity (Waystar,

Change Health)

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Comprehension of CPT, ICD-10

Diagnostic and Procedural Coding

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• HCPCS/Modifiers

Checking eligibility and Benefits using

Availity and DHCS medical portal

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Submitting electronic claims and

mailing CMS-1500 forms with proper

documentation and EOBs

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• Microsoft Word, Excel, and PowerPoint

Complete understanding of appeals

process, claims, tracking, and

follow-ups.

•

• Collections and Reimbursements

Acquainted with Medicare rules and

regulations

•

Contacting Insurances regarding claim

denials, missing information or

underpayments, and overpayments

•

Resolving claim mistakes or missing

information and resubmitting

•

Experience in accounts receivable,

collections

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Reviewing, updating, and correcting

Patient Information

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• Reviewing remittance advice batches

Answering calls from pts about

payments and copays

•

• Claim Processing, Benefits Verification

Posting of payments, denials

approximately 230+ a day

•

PROFESSIONAL SUMMARY

I strive in becoming a proficient Medical collector. In order, to assist people receive the care required. Driven to take on new challenges to exercise newly learned skills while I grow in my position.

WORK HISTORY

Medical Insurance Collector, 11/2022 to 07/2023

KPC Healthcare - Santa Ana, CA

Medical Billing Clerk, 11/2021 to 11/2022

Premier Infusion & Health Care Services - Gardena, CA Medical Biller, Accounts Receivable, 05/2021 to 11/2021 Acclaim Recovery Management - Torrance, CA

Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.

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• Verified patient insurance coverage and benefits for medical claims. Researched and resolved complex medical claims issues to support timely processing.

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Entered client details and notes into system for interdepartmental access and review.

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• Researched billing errors and discrepancies to initiate corrective action.

• Worked with several insurance portals, and have a great understanding or Paragon as well as sunrise medical management software.

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• Worked with authorizations and have a strong understanding. Communicate with insurance providers to resolve denied claims and follow up on resubmitted claims

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Review patient records, identify medical codes, and create invoices for billing purposes.

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• Post payments and Denials approximately 230+ a day Analyze complex Explanation of Benefits forms to verify correct billing of insurance carriers.

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Gather information from multiple insurance sources to simplify billing and organize accounts.

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• Deliver timely and accurate charge submissions.

• Review patient diagnosis codes to verify accuracy and completeness.

• Prepare billing statements for patients and verified correct diagnostic coding.

• assisted with speaking to patients and help them set up payment plans. Communicated with insurance providers to resolve denied claims and resubmitted.

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• Posted payments and collections on regular basis. FRANCISCO MENDEZ

• Filed and updated patient information and medical records.

• Collected payments and applied to patient accounts. Reviewed patient records, identified medical codes and created invoices for billing purposes.

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EDUCATION

Medical Billing And Coding Certification : Medical Billing & Coding, 02/2021

North-West College-Long Beach - Long Beach, CA

Contact this candidate