Data Entry Medical Billing

Criselda Ruiz

Email: *************@*****.*** Cell: 562-***-****

Objectives:

Seeking a position with a company, with great opportunities and growth for a non-profit Organization.

Position Summary:

Administrative responsibilities

Experience:

PSE- Program Service Evaluator 3 5/4/2020- 8/26/2022 Professional Experiences

● Complete initial eligibility determinations and annual reviews for AHCCCS Med-ical Benefits, Medicare Cost Sharing programs, various Specialty programs, and Acute Care eligibility.

● Conduct interviews with customers by phone and in person; gather financial in-formation.

● Review applications and correspondence in Fortis and OnBase; obtain verifica-tions.

● Data entry of eligibility information into the HEAplus eligibility system.

● Complete all appropriate legal documents needed for processing.

● Explain benefits/responsibilities to clients. Record a detailed description of all the specific actions taken on a case.

● Utilize information found in program manuals and interpret Local, Regional, State and Federal rules and regulations/policy and procedures.

● Manage a large caseload; meet established productivity, quality and timeli-ness standards.

● Work special reports, projects, and complete online referrals in PMMIS specifical-ly assigned by Management in an accurate and timely manner.

● Assist with supervisor duties when the unit supervisor is not available or when the office is backed up. Assign work duties to Unit Staff, review productivity and update data logs. Professional Experiences

• Managed 36 office accounts over 2,000 with less than 4%exceeding 60 days past due

• Counseled customers with delinquent accounts to ensure continued service

• Reconciled problem accounts to ensure billing accuracy

• applied $500k daily in credit cards and check payments

• Review aging Reports, identify problem accounts and take appropriate action

• supervise a staff of Two

• Administer all department daily task

• Review all credit files, assess risk and assign all credit lines

• Mentored, coached collection and support staff

• Support sales growth of the company by managing risks and collecting payment

• Communication with associated branches to resolve incorrect invoices

• Assist in year-end independent audit as needed

• Handle customer calls and Accounts

• Responsible for overseeing the operational function close with the Account receivable manager

Job related skills:

Medisoft – Medical Billing Software Appeal

Letters/Correspondence

Aging Reports / Follow-up Posting Charges /Payments on Account CMS 1500/HCFA, UB04/UB-92, ADA Forms ICD-9, CPT, HCPCS, and CDT Coding

Entering Demographics Scheduling Appointments

Medcin – EHR Forms

Customer Service, contacting doctor as needed

Medical Records

Maintaining the safety of the patient/s

HIPPA/ CMS Compliance

Am and Pm care as needed with ADL’s Typing 35 wpm/10 Key Medical/ Dental Terminology

Medicare/Medical guidelines

Insurance verification

CPR-American Heart Association

Claims Examiner

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