Seeking a position with a Healthcare Company, that will offer stability and possible opportunity for growth.
Typing – 60 WPM
Internet & Email
Medical Claims Examining
Dental Claims Examining
HMO, PPO, POS
American Career College 2/2010 – 10/2010 Anaheim, CA
*Diploma: Health Claims Examining Medical Billing
*Certificates: Honor roll, Perfect Attendance
United Educational Institute 4/1998 – 11/1998 Santa Ana, CA
*Certified: Medical Assistant
Santa Ana Valley High School Santa Ana, CA *Diploma: High School Diploma
Collections Insurance Specialist
Cenikor Foundation - Houston TX - March 2019 to July 2019
Worked aging accounts and clean up AR
Worked fast pace productivity and quality was expected and met
Worked accounts accurately and timely to increase revenue cycle.
Check emails for assigned tasks for the day
Worked both commercials and self pay collections
Worked both in - network and out of network claims
Prepared and submit our own appeals for denials if need be.
Worked remotely from home on assigned days independently
Initiate and prepare refund requests of recoupment or self pay refunds.
Worked on a in house system called Welligent
Worked on EOB s daily to update status
Notated accounts and rupdated resolved claim issues to better the productivity
AR Collections Specialist/ Claims Analysis
Ascent Revenue Management – Houston, TX – September 2016 to June 2018
Work AR for two large clients involving billing for Gastroenterologist and Liver Associate LAB and Gessner Anesthesia Associates
Billing claims out of a network for this one particular client
Calling Insurance to get claims reprocessed with in network.
Appeal claims on patient behalf.
Adjustment made to patient accounts, when insurance pay 80% on a claim.
Dealt with patients, explaining how claim was processed. Why the claim went out of network.
Also answer phones, took patient payment on patient accounts.
Work on nextgen System.
Alegis Revenue Group Med Data, LLC - The Woodlands, TX – 06/2015 – 06/2016
Worked different accounts every day.
Returned accounts, initials, follow-ups
Done Appeals know how to put one together
On the phones following up on claims
Check status of a claims.
Verified insurance. Also following up on Appeals. Worked in many different hospital systems
Resolve account issues
Make sure my initial would be in great details for follow ups.
Always on phone with insurance company to resolve matters.
Making sure the client is happy. The accuracy and timely manner of the work I did at Alegis is a big impact to them
I have a strong understanding of a billing and coding background. That gives me knowledge and understanding of knowing how to follow-up on claims or Appeals. Knowing how to put an initial together. Calling and verifying eligibility and dealing with insurance companies over the phone.
Blue Cross of Idaho 10/2014 – 03/2015
Provide accuracy data entry
Verify accuracy of data entry correct any miss findings
Knowledge of ten keys and can use with accurate speed
Knowledge of system used like SAM and Facets to complete work
Provide good customer service in updating and keeping good records
Prepare detailed reports on audit findings
Examine and evaluate financial and information systems
Ensure system reliability and data integrity
Review data about material assets, net worth liability, capital stock and income
Collect and analyze date to detect deficient controls, duplicated effort, fraud, regulations and management policies
Data Entry/ Medical Biller
Magella Medical Group Inc 04/2011-06/2013
Enter patient information on data base, charges for high risk pregnancies, bill PPO, Medical and Medicare insurance also code procedure performed on patient, resolve patient billing problems
verified insurance and patient eligibility, Conduct self in accourdance with HPA’s employee manual, request patient information or chart from hospital, operate a multi-line telephone
Responsible for collecting, posting and managing account payments, billed Blue Cross, Blue Shield, Aetna, PPO and HMO also balance accounts in the end of the day
Submitting claims, follow up on claims with insurance company, processes payments
Answered patient questions, clerical staff and insurance companies and sometimes also schedule patient appointments. Prepared, reviews and send patient statements
Health Claims Examining Medical Billing (internship)
Bienestar Medical Center 10/2010-11/2010
Greeted and took patient information, answered phones in a professional manner
Scheduled appointments, filed, looked up patient, billing insurance, PPO, Medicare, Medi-Cal
Billing for birth control, STD’s, blood test and pregnancy testing
Worked front and back office, data entry, Microsoft Word, Microsoft Excel, Outlook
Medical Terminology, CPT Coding, ICD-9 Coding, UB-04s, HIPPA Guidelines
Checked for eligibility of patient, collection and coding and 10-keys
Executive Assistant/ Receptionist/ Medical Device
MiCardia Corporation 09/2009-06/2010
Greeted and directed clients and customers, Purchased office supplies as needed
Assisted with staffs assessments and preparation for board meetings and presentation plans
Answered phones in a professional manner, Scheduled appointments or travel arrangements
Data Processing / Business Office 11/2006-06/2008
Bristol Park Medical Group
Processed about 100-200 fee tickets per day, worked well within deadlines demanded of me
Made sure patient is covered with medical or insurance on fee tickets
Worked with insurance companies like Blue Cross, Blue Shield, HMO’s PPO’s
Processed fee tickets for radiologists for x-rays, Knowledge of CPT codes and medical terms
Medical Assistant/ Receptionist
Hoag Hospital 09/2004-10/2006
Provided patients with information and support, well organized and detail-oriented
Answered multiple phones and performed data entry, filing, faxing and other clerical duties
Assisted with insurance billing, Reports to billing supervisor or named Office Manager
Familiar with Workers Compensation, posting and managing patient charts