SUMMARY

SKILLS

EXPERIENCE

LUCENA ESPEJO

Honolulu, HI 96819 C: 808-***-***** adbso1@r.postjobfree.com Results-oriented Medical Biller with excellent organization, communication, relationship-building skills. Multitasking Medical Biller with career spent submitting claims quickly and efficiently to insurance companies. Bilingual individual with can-do demeanor positive attitude. Ready to tackle new challenges in an office-based environment.

Medical and dental Insurance

billing

Problem solving

Knowledge of Medical

Terminology and knowledge of

ICD-10 and CPT Codes

Excellent time management,

team player

Detail-oriented

09/2019 to Current Medical Biller Manager

Crnewton Honolulu, HI

Monitored multiple databases to keep track of all company inventory. Overseas operations of the billing department.

Analize billing and claims for accuracy complishnes. Submit claims to proper insurance entities.

Follow up on any issues.

Planned and executed Medical billing responsibilities. 07/2017 to 08/2019 Nurses Aide

Waialae Senior Living HONOLULU, HI

Fostered relationships with patients, caregivers and healthcare teams to achieve individual care plan targets

Documented patient intake and dietary requirements and assisted with feeding

07/2003 to 03/2012 Medical Biller/Adult Foster Home Operator Self Employed WAIPAHU, HI

Performed insurance verification, pre-certification and pre-authorization Effectively coordinated all communications between patients, billing personnel and insurance carriers

Accurately input procedure codes, diagnosis codes

Submitted claims electronically

01/2001 to 06/2003 Patient Account Representative

Nephrology Consultants Of Hawaii HONOLULU, HI

Accurately entered procedure codes, diagnosis codes and patient information into billing software

Determined customer eligibility for benefit programs and services Completed appeals and filed and submitted claims

Accurately posted and sent out all medical claims

Confirmed patient demographics, collected copays and verified insurance

EDUCATION AND TRAINING

Applied payments, adjustments and denials into medical manager system Performed quality control of the data entry system to verify that claims and payments were posted correctly

Consistently informed patients of financial responsibilities prior to services being rendered

Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans

Identified errors and re-filed denied or rejected claims in a timely manner Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house

Reached out to patients once insurance was billed in order to obtain payments due

Processed refunds, disbursements and payments

Coordinated between patients and healthcare professionals to meet patient needs

Ran statements each month to review outstanding balances and identify accounts in need of collection processing

Resolved inquiries from patients, families and external payers 01/1999 to 12/1999 Patient Account Representative

Kaiser Permanente HONOLULU, HI

Generated detailed reports outlining billing, flagged items and other important data

Collaborated with all relevant parties to resolve billing issues, insurance claims and patient payments

Checked claims for errors, corrected issues and mailed out in a timely manner

Utilized customer service skills and detailed system knowledge to support hospital and clinic operations

07/1995 to 12/1998 Medical Claims Processor

Hawaii Medical Service Association Honolulu, HI

Was responsible for efficiently and effectively processed a large volume of medical and dental claims on a daily basis

Was responsible for inputting data into the system, ensuring that provider coding information and reported services were correct Was responsible for analyzing and calculating coordination of Benefits of information. Interpret group benefit plan coverage 01/1991 to 06/1995 Medical Claims Processor

Hawaii Dental Service Honolulu, HI

Was responsible for resolving medical and dental claims by approving or denying.Examining and adjusting claim

Was responsible processing coordination of benefit claims Medical Billing And Coding

Ashworth College

Bank Teller/Operations Clerk

Hawaii Business College Honolulu, HI

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