Medical Billing and Coding
Resume:
Justina Villarreal
La Habra, CA *****
*******.*************@*****.***
Willing to relocate: Anywhere
Authorized to work in the US for any employer
Work Experience
Medical Biller and Coder
Premier Ambulance
February 2024 to July 2024
• ICD-10 and CPT coding
• Adding the correct modifiers
• Billing Medi-Cal, Medicare and Comercial Insurances
• Requesting TARs
• Sending corrected Claims
• Complete health plan billings based on requirements.
• Compile proper paperwork and conduct appropriate research to appeal claim denials, including requests for refunds/credits when applicable.
• Review and monitor reimbursements due from different payors to determine appropriate collection methods.
• Communicate effectively and professionally with external customers.
• Resolve payment issues with carriers, (e.g. denials, partial payments, etc.)
• Review, modify, and re-bill rejected/denied claims.
• Assist Cash department on payor backup as needed for payments received.
• Adhere to and comply with information systems security. Know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered, and report information system security problems.
• Adhere to all company policies and procedures.
• Work overtime if assigned by Management.
• Perform other duties as assigned.
• Be flexible with shifting daily priorities.
• Met deadlines, working within tight time constraints.
• Handled a large volume of work credits
• Exceed established standards for productivity and quality. Patient Navigator
MemorialCare-Fountain Valley, CA
February 2022 to December 2023
• Answer all incoming calls for all doctor offices, hospitals, and urgent cares,adding new patients to EMR, scheduling appointments, sending encounter notes to office, verifying authorizations, requesting refill medications.
• Verified insurance information, collected payments, and scheduled appointments.
• Informed patients about payment options, billing policies, and procedures related to their visit or procedure.
• Help patients with their My Charts.
• Helping patients with their billing questions.
• Scheduling patients’ appointments.
• Sending messages to the doctor for patients.
Patient Account Representative
WorkCare, Inc-Anaheim, CA
December 2018 to February 2022
• Check emails from Clients and their employees.
• Answer phone calls and return calls.
• Did Medical billing, Payment collections, Insurance billing/updating and Payment posting.
• Call clinics and scheduling appointments for Annuals and Drug screens for the employees.
• Entering the information into OHM.
• Emailing the employees their appointment information.
• Answering questions from clients.
• Taking care of client specific needs.
Medical Coder
CARE AMBULANCE-Orange, CA
March 2017 to June 2018
• Invoiced 100 accounts pre-day
• ICD 10 coding for Medical in Orange, Riverside, and LA counties.
• Generated 100 narratives pre-day
• Summited case files to the insurance companies
• Posted payments from insurance companies to approximately 100 accounts pre-day
• Assisted with collections and insurance verification Billing Clerk and inpatient coder
HELP Staffing/ CHOC Children's Hospital-Orange, CA October 2016 to February 2017
• Pulling up information on NeoData and printing out patient information for coding department.
• Printing face sheets and looking up authorization numbers from Citrix Receiver.
• Experienced with Chart Maxx Chart Navagator, Net Scaler Gateway and Ebrige.
• Scanning, copying, faxing, assisted with sorting and distribution of mail
• Certified Coding Specialist, coding for all sensitive cases using ICD 10 and CPT codes. Externship Medical Billing and Coding
SUNRISE MEDICAL GROUP
June 2016 to July 2016
Inputting of Super bills for Workers Comp and Drug screens/ Physicals for pre-employment, Insurance, and Checks into the system.
• Coding from CPT, ICD 10 and HCPCS.
• Getting CMS 1500s ready to be sent out to the insurance companies, and then mailing them out.
• Making Copies and Filing.
• Collection calls
• Working on EOBS and aging
Education
Vocational school in Medical Billing & Coding
American Career College Anaheim - Anaheim, CA
November 2015 to July 2016
Skills
• ICD (4 years)
• BILLING (4 years)
• CPT (4 years)
• CODING (4 years)
• COLLECTIONS (4 years)
• ICD-10
• Medical Billing
• ICD-9
• Medical Records
• EMR Systems
• Insurance Verification
• Patient Care
• Medical Coding
• Medical Scheduling
• Medical Office Experience
• Anatomy Knowledge
• ICD-10
• Medical coding
• ICD-9
• Medical records
• Medical terminology
• Epic
• ICD coding
• EMR systems
• Documentation review
• Workers' compensation law
• Anatomy knowledge
• Hospital experience
• Customer service
• Analysis skills
• Typing
• Accounts receivable
• Revenue cycle management
• Cash handling
• Windows
• Microsoft Access
• Clinical documentation improvement
• Data analysis skills
• Computer networking
• Content management systems
• Adobe Acrobat
• VPN
• Physiology knowledge
• Pediatrics
• Cash register
• Sales
• Budgeting
• Project management
• HIPAA
• Records management
• Customer relationship management
• Accounts payable
• Data entry
Certifications and Licenses
Certified Professional Coder
Certified Coding Specialist
Medical Billing Certification
Driver's License
Medical Coding Certification
Certified Coding Associate
Assessments
Attention to detail — Proficient
January 2024
Identifying differences in materials, following instructions, and detecting details among distracting information
Full results: Proficient
Scheduling — Proficient
December 2023
Cross-referencing agendas and itineraries to avoid scheduling conflicts Full results: Proficient
Medical billing — Proficient
December 2023
Understanding the procedures and forms used for medical billing Full results: Proficient
Work style: Reliability — Proficient
January 2024
Tendency to be reliable, dependable, and act with integrity at work Full results: Proficient
Protecting patient privacy — Proficient
December 2023
Understanding privacy rules and regulations associated with patient records Full results: Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
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