Customer Service Medical Billing
Resume:
Yolanda Carrillo
*******@*****.***
Profile
Qualified individual with 15+ years in Front Office/Medical Billing & Collections and 10+ years of experience in Child Nutrition Management within K-12 Schools is seeking a position to utilize my excellent customer service skills and coordination capabilities to benefit a company.
Experience
Patient Financial Service Rep. 03/20-02/2021 Banner Health 602-***-**** Claims resolution to include follow up on unpaid claims within standard billing cycle timeframe by contacting payor via phone or website, resolve denials, appeal submission, rebill claim with corrections as necessary . Medical Claims Processor 07/19-10/03/19 Reqroute/Cognizant 408-***-**** Adjudicate claims to process according to member eligibility, benefits, prior authorization, CPT/ICD10 codes for professionaland hospital claims. Health Info Specialist 03/19-07/12/19 KForce/MIHS 602-***-**** Retrieve existing medical records by gathering appropriate record folders and contents, assigning and recording new record numbers, verifying existing record numbers, inputting and recording locations to EPIC system. Case Manager 11/18-01/19 Remx/Mckesson Specialty Assignment 602-***-**** Demonstrated knowledge of HIPPA privacy and security regulations by appropriately handling patient information, precisely evaluated and verified benefits, eligibility, pre-certification and prior authorization. Actively maintained correct working knowledge of CPT/ ICD10 coding principles, effectively entered procedure codes, diagnosis codes and patient information into billing software. Provide excellent customer service. Assistant General Manager 07/08-10/18 SFE/Nogales Unified School District 480-***-**** Overall operations of the Child Nutrition department, to include, employee supervision, staffing and staff development, maintain and monitor cost to stay within budget by purchasing and inventory control. Plan, organize, hands on training and coaching on policies, procedures and guidelines to ensure compliance according to federal, state, and local policies. Patient Account Rep. 07/04-09/06 Catholic Healthcare West 602-***-**** Maintained all collection activities for government and managed care payers, obtained payments by contacting insurance carriers regarding claim status and claims not paid within a predetermined time, submitted written appeals to payers on denied claims for adjudication and resolution, applied provider payments on accounts accordingly, resolved customer billing inquiries and disputes. Provided excellent customer service. Patient Account Rep. 12/02-05/04 Southwest Women’s Care 480-***-**** Preparing, reviewing and transmitting claims using billing software, follow up on unpaid claims within standard billing cycle timeframe, checking each insurance payment for accuracy and compliance with contract discount, researching and appealing denied claims, identify and bill secondary insurance, answer all patient or insurance telephone inquiries. Provided excellent customer service. Sr. Account Rep/Front Office 08/01-04/02 &1990-1997 Banner Health System 602-***-**** Maintained all collection activities for government and managed care payers, obtained payments by contacting insurance carriers regarding claim status and claims not paid within a predetermined time, submitted written appeals to payers on denied claims for adjudication and resolution, applied provider payments on accounts accordingly, resolved customer billing inquiries and disputes. Front office, check in/out patients, actively entered procedure codes, diagnosis codes and patient information into billing software, precisely evaluated and verified benefits and eligibility, efficiently performed insurance verification, pre-cert and prior authorization functions, scheduled appointments, collected patient liability. Provided excellent customer service.
Skills
• Medical Front Office/Billing & Collections Revenue Cycle
• Working Knowledge of HCPCS, CPT & ICD10 codes.
• Strong Customer Service & Organizational Skills
• Computer Literate
• Microsoft Excel, Word and PowerPoint
• Problem-solving skills.
• Knowledge of medical terminology.
• Fluent both in English & Spanish
Contact this candidate