Adriana Serrano

***** **** *** *

Graham, WA. ***38

Phone # 253-***-****

Email: ad4p09@r.postjobfree.com

Summary of Qualifications

• Experience in high volume detailed information processing and reporting

• Extensive experience working in multiple computer applications including EPIC, E-Premis, Onbase and McKesson Star.

• Excellent reputation with staff as knowledgeable and helpful billing resource

• Productive and responsible. Willing to learn and handle any tasks needed.

• Go above and beyond my duties and responsibilities.

• Bilingual in English and Spanish

• Microsoft Word, Excel & Outlook

• Team player

Relevant Skills & Experience

Customer Service

• Developed a reputation for excellent customer service by responding promptly and professionally to requests from co-workers, patients, insurance companies and other healthcare providers.

• Consulted with clients family to address any concerns regarding the clients health,financial aid, nutrition and overall well-being.

• Perform manual and electronic posting functions for all Managed Care, Commercial and Government payers for all patients accounts, including cash balancing and reconciliation of bank deposits.

• Maintain knowledge of insurance rejection/denial processing and appropriately posts information for collection and follow up activity.

• Maintain daily cash log within excel tracking payment posting completion level.

• Post payment corrections, payment transfers, NSFs, inter-facility transfers, payroll deductions and any other cash transaction for A/R accounts according to established guidelines.

• Research and clear Unapplied Accounts(bank, MCare, Mcaid) using established identification function/process.

• Reconcile bank and special accounts which may include: research,payment transfer, or payment refund.

• Process all patients credit card payments and refund request. Administrative

• Perform administrative functions such as developing reports, review medical records actions and outgoing correspondence with insurance companies.

• Monitor suspense files, records distribution and reporting requirements.

• Follow up with insurance payers to research and resolve unpaid insurance account receivable. Make necessary corrections in the practice management system to ensure appropriate reimbursement is received for all providers.

• Identify potential trends in denials/reimbursement by payer or by type, denial reason, or coding issue and report to supervisory staff for appropriate escalation.

• Document all activities documentation, maintain confidentiality of medical records.

• Managed and processed all pharmaceutical payments to patient accounts to the appropriate account and date of service.

Trouble Shooting/Research

• Submit claims to government agencies, medical services bureaus and insurance companies ensuring that accounts are billed appropriately by auditing charges to ensure accurate procedure codes, billing data and patient information submitted.

• Submit all outpatient claims MediCaid including HMO’s and out of state MediCaid and Health insurance

• Address all information requested from payers and trace all claims to those payers making sure they have been paid or denied appropriately and in a timely manner.

• Research missing patient payments and insurance payments.

• Payment research for our contracted providers and patient payments. Employment History

Billing Specialist II October 2021 – February 2022 ICHS Renton, WA Reconciliation Rep December 2020 – September 2021 ValleyCities BH, Federal Way, Wa Reconciliation Rep October 2018 - September 2019 Conifer Health/FHS,Tacoma WA Billing Specialist June 2018 - October 2018 Seattle Indian Health, Seattle WA Payment Poster March 2010 - June 2018 Conifer Health/FHS, Tacoma WA Customer Service Rep July 2007 - March 2010 Franciscan Health, Tacoma