Follow Up Insurance Specialist
Resume:
Cynthia Lameira
Insurance Specialist -Accounts Receivable
Fresno, CA 93722
************@*****.***
Seeking Long Term Position with Advancement Possibilities. Authorized to work in the US for any employer
Work Experience
Insurance Specialist - Remote
PFS - Patient Financial Services-Fresno, CA
November 2014 to Present
Review patients accounts for non-payment. Follow up with commercial payer, and submit the requested documentation or appeals, as needed. Work assigned special projects as requested. Medical Insurance Specialist
ACES - All Care Equipment and Supplies.-Fresno, CA March 2011 to August 2014
Responsible for Monthly Billings of Commercial Accounts, Follow up on non-payment denials, appeal as needed..Patient Statements are reviewed and mailed monthly. I processed and applied payments to accounts,. Preparing bank deposits for management. Responsible for verification of insurance eligibility, benefits and obtained authorizations as needed.
Billing Specialist
Ray Fisher Pharmacy-Fresno, CA
June 2009 to March 2011
Responsible for preparing and submitting claims to Medicare Follow up of Medicare aging and denials. Submit appeals to the appropriate Medicare appeal level for review of denied payment of prescribed DME. Assigned special projects of $90,000.00 Custom Wheelchairs denials and $15,000.00 of denied Medi-cal Medical Group denials. Assist manager with Medicare updates and changes due to LCD changes.
Medical Biller
Hadden Pathology-Fresno, CA
March 2008 to August 2009
Prepared Commercial Account Invoices, patient statements Follow up, auditing and account adjustments, collection of outstanding payments on account. Auditing of accounts and account preparation for FCB referral due to non payment
Lead Billing Specialist
MK Medical-Fresno, CA
January 1991 to July 2004
Responsibilities included preparing and submitting claims to all payer sources with the required documentation. Follow up of past due open accounts, appeal denials with the required documentation requested. Auditing of accounts, adjusting accounts according to Contractual Agreement. Prepared accounts to FCB for outstanding account debts.
Special Project Collection Team:
Department was created for follow up and collection of outstanding revenue totaling over one million dollars. Collection of revenue required generating and submitting appeals, submitting medical justification for all payer sources. Auditing of accounts for accuracy and payments. Rehab Tech Assistant:
Position responsibilities included set up of patients account, verification of insurance coverage and benefits. Request authorizations, Tar(s), CCS authorization. Education
High school or equivalent
Skills
• Epic Software, Emdeon Software. Type 50 WPM, 10 Key, Microsoft Word & Excel. (10+ years)
• Microsoft Excel
• Microsoft Word
• Medical Billing
• Insurance Verification
• Medical Coding
• Auditing
• ICD-10
• Accounts Receivable
• CPT Coding
• Medical Records
• Medical Terminology
• ICD-9
• Medical Office Experience
• Hospital Experience
• Anatomy Knowledge
• Clerical Experience
• Typing (10+ years)
• Multi-line phone systems
• Customer service
• Documentation review
• Phone etiquette
• HIPAA
• Data Entry
• Experience Administering Injections
• ICD Coding
• Benefits administration
• Account reconciliation
• Medical collection
• Managed care
• English
• Microsoft Office
• Microsoft Outlook
• Accounting
• IVR
• CPT coding
• Medical coding
• ICD coding
Additional Information
SKILLS: Epic Software, Brightree, Pacwin, Medical Manager, Microsoft Word and Excel, Typing 45 WPM and 10 key.
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