Medical Billing Specialist
Resume:
Danelys Diaz
adrt7y@r.postjobfree.com
Objectives
I seek to join a team where I can practice the many skills that I have developed over the years in managing the billing department at a number of successful Home Health Agencies. Professional Summary
Medical billing specialist with 19 years of experience in Medicare, Medicaid, Commercial, Long Term Care and Worker's Compensation insurance. Continued education in all matters of office administration, with ample experience in working efficiently within teams of healthcare providers. Decorated with many hours of teaching staff members in intricate billing software and proper coding of insurance claims. Education & State Licenses
Certified Medical Biller and Professional Coder
Florida Career University
2004
Oasis Certification
Home Health Association
2006
Florida Real Estate and Finance Course
Broward College
2015
Focused Skills Summary
Extensive knowledge of all aspects of Home Health Medical billing, policies and federal/state laws.
Experience in working with medical insurances such as, but not limited to; Allscripts, Florida Medicaid, Medicare EDI, Ability, Availity, Carecentrix, SunshineHealth, Simply Healthcare, Integrated, Aetna, WellCare, Humana, StayWell, LHNAC, Molina Healthcare, United Healthcare, FCC billing system.
Understanding of eligibility verification and authorization of insurance.
Performing accounts receivables.
Up to date in HIPPA compliance.
Ability to perform posting and reconciliation.
Expertise in CPT and HCPCS coding.
Many years of experience working with Medicare ADR.
Fluent in Spanish.
Professional Experience
Independent audit and billing consultant
Responsible in identifying errors and assist in properly adjusting insurance claims.
Fluidly assist in the coordination of new insurance financial contracts and compliance with all terms to stay up to date with the dynamic nature of insurance claims.
In charge of preparing reports in order to provide guidance to administrators and office managers on potential financial risks and overall financial control within the company.
2008 to Present
Billing manager at A&A Health Service
In charge of supervising the day to day functions of the billing department and streamlining the payment collection process.
Identifying and correcting shortcomings in the billing system in place.
Constantly working on quality assurance to guarantee improvements within the billing department.
In charge of reviewing analytics to provide annual billing budget information and constructing means to review the data to allow administrators to monitor expenses, identify deficiencies and implement corrective actions.
Ensure that the various medical personnel and new employees are fully trained within the department.
Review disputed insurance claims, and efficiently provide solutions to expedite payouts.
Monitor payments and medical bills for all active and discharged patients.
Supervise electronic claim transmissions, reports and payments.
Deal diligently on a one-to-one basis with the insurance companies. July 2005 to Present
Office and billing clerk at Renacer Home Health
Responsible for skilled and private duty home health billing.
Review and audit charts for accuracy.
In charge of sending claims and posting payments.
Investigate and analyze past due claims, account receivables.
Supervise authorizations for service.
Check eligibility and benefits for patients.
Prepare monthly-end reports.
2000 - 2005
References
Raul Camacho, CEO at PN System
adrt7y@r.postjobfree.com
Efren Diaz, MD candidate
adrt7y@r.postjobfree.com
Michelle Flores, Recreational therapist
adrt7y@r.postjobfree.com
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