Medical Billing Insurance
Resume:
Lori de Castro
*********@*****.***
Summary
Results driven medical billing specialist with 13 plus years of experience. Well versed in managing medical insurance claims and investigating and resolving insurance company disputes. Excellent and effective written and verbal communication skills with internal and external stakeholders, such as patients, disclosing account balances and claim statuses. Identifying hidden revenue by uncovering process inefficiencies, coding errors and claim denial patterns.
Key Skills
•Expert in 10 Key Touch.
•Bill 200 claims daily with 99% accuracy.
•In 4 years, supported a growing practice from 1 full-time, 1 part-time doctors to 3 full-time doctors.
•Increased insurance revenue by 10% annually within the last 4 years.
•Worked with Allscripts, PayDC, and Kareo software.
•Knowledge of ICD-9, ICD-10, CPT coding and 3rd party insurance including Medicare.
Education
Bryman College Sept 2001 - Oct 2002
Diploma with Honors in Medical Assisting
Experience
ChiroPlus Clinic, Medical Billing Specialist July 2016 to Current
•Manage Billing and Claims department at a private chiropractic office.
•Identify medical coding procedures or fee errors and omissions, making necessary adjustments to patient accounts dependent on negotiated rates.
•Implement new systems for State Law compliancy and financial efficiency.
•Train incoming employees as needed to help the office run efficiently.
•Submit primary and secondary clean claims to insurance companies within 24 hours of patient appointments.
•Accurately interpret EOBs and post EFT reports to patient ledgers to kept accounts as up to date as possible.
•Verify insurance benefits and prepare financials for patients to start treatment.
•Credential and complete medical insurance contracts for doctors.
•Run weekly A/R aging reports to decrease accounts in A/R and receive payment from insurance companies, attorneys, and PIP companies.
•Run bi-monthly appointment generation claims reports to guarantee all claims are billed out within that month.
•Balance and close the billing system each month to insure it is balanced and the P/L is accurate.
•Provide insurance companies with additional documentation or recorders (if requested) to expedite payments and resolve denials.
•Answer phones which include scheduling patients, billing questions and filtering which calls the doctors need to take.
•Plan events while working with the surrounding community to help raise money for local charities.
•Help maintain employee efficiency and resolve office issues when they arise.
•Billed DME to 3rd party insurance companies including Medicare.
Southern Orange County Pediatrics, Medical Biller June 2005 - June 2014
•Posted all paper EOBs, ERAs, and patient payments to billing software for 5 pediatric offices daily.
•Served as point of contact for patients with account inquiries regarding insurance claims and account statements.
•Refiled denied/rejected claims as they were received to insure payment.
•Contacted insurance companies regarding unpaid claims or denials and provided payer with required information to speed up the process of approval and payment.
•Kept clear and detailed notes in the EMR system to insure everyone was up to date on the account status.
•Planned quarterly team building meetings to unify the billing staff.
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