Laura Bedolla

310-***-**** adub7c@r.postjobfree.com

Summary of Qualifications

I’m a Bilingual Biller/Collections Specialist with a CPC- Certified Professional Coder License, and also ICD-10CM certified both accredited by AAPC currently seeking to land a position as a Leader/Supervisor within Billing/Collections and Coding field with a well- established company. My objective is to succeed at everything that I challenge myself in. I’m a perfectionist, independent, and responsible, with an ability to multi-task. Knowledge in accounting, appeals, specializing in business/collection management Billing/Collections and also Workers Compensation Billing, Clinic Compliance and A/R. Overall knowledge of the use of ICD-10CM, CPT, HCPCS Level II and the use of Modifiers as well as E/M codes and the use of CMS-1500 and UB-04 forms. Also have Knowledge of Medical Terminology and highly knowledgeable with Epic Systems. Open to learning different systems and have used many different systems in my 13 years career within the Medical Field. Excel, Word and Outlook savvy.

Experience

Prime Healthcare

11/2020-10/2021

EOB Analyst (Centinela Hospital)

Review, audit all Claims and EOBs for accuracy of proper coding of Risk Management and Adjustment, process all EOBs, submit EOB’s for appeals, and or corrected claims, review insurance for accuracy before submission, post patient responsibilities Co-pays, Co-ins, and Deductibles, make sure that correct insurances are being billed for claim submissions, make sure accurate patient responsibility is being applied, making sure insurance payments are being posted under correct insurance I-plan as well as correct insurance I-plan is being billed work off of Excel spreadsheets, use Word, Outlook, use of all insurance contracts, utilize all Medicare calculators, Medi-call calculators for all Inpatient and Outpatient claims, price all inpatient and outpatient claims for hospital as well as review accounts to make sure timely filing is being met as well as making sure follow-ups are being met on submitted corrected claims and appeals. Post and submit daily batches at end of day. Currently do Hospital Billing with the use of UB-04 forms and E/M codes, Systems used here are MediTech, OneContent, Axiom, and CMS web pricers.

BlueShield of California

10/2020-3/2021

Member Level II Processor

Processed all new member applications, updated existing member accounts with new address, phone number, debit card information for autopay purposes etc. Lots of data entry handled high volume of incoming emails, handled high volume of incoming electronic fax, worked voicemails, logged each account worked on a excel spreadsheet and attended every Billing department meeting with BlueShield. Used excel, word, outlook and electronic fax and voicemail. Systems used here were Facets, Trizetto, and Marx.

MJ Resource

3/2020-4/2020

Billing/Collections Specialist

Handled all Behavioral A/R claims for Clear Recovery facility and Neuro Wellness facility. My duties there were handling all Collections accounts, verified insurance and patient eligibility. Was constantly on the phone with insurances to get details on denials and getting resolutions to get claims paid. Sending corrected claims along with corresponding documentation, worked off of EOBs sent daily EOBs to Supervisor, worked off of Excel spreadsheet to log accounts worked on and completed. Also documented every account worked on, inputted correct CPT codes and DX codes that were documented on patient report. Knowledge of the use of ICD-10CM also certified, HCPCS Level II codes and Modifiers. Systems used here were DrChrono, CollabMD and Kipu.

UCLA Pathology Depart.

8/2013-1/2019

Billing/Collections Specialist

Started in Client Billing, was also trained in Hospital Billing, Professional Billing and Risk Management and Adjustment coding. My duties there were answering phones, verifying insurances, submitting and correcting claims, submitting appeals, working denials and Coding reports. Was also trained in working Governmental Hospital AR billing and AR follow up, posting charges, credits and adjustments, also obtaining authorizations for HMOs. Molecular testing/billing & Coding, flow Cytometry, MUE’s, FNA’s Cell block, frozen sections. Also obtaining authorizations for all HMO Insurances, auditing patient reports. Working daily voicemails and updating patient demographics. Knowledge of all third- party insurances, commercial BC, BS, Cigna, Aetna, all HMO’s also knowledge of Medicare, Medicaid, Medical and CCS. Also expirience with the use of CMS 1500 and UB-04 forms. Knowledgeable with Medical Terminology. ICD-9 CM, certified in ICD-10CM, CPT, HCPCS Level II codes, the use of Modifiers and experienced in Risk Management and Adjustment coding. Systems used here were Epic, Beaker, PowerMD, Moxee, AMD etc.

Pathology, Inc.

01/2012-7/2013

Billing/Collections Specialist

Handles all Billing for laboratory, answering phones, verifying insurances, verifying eligibility worked with all commercial insurances HMOs, PPOs and all third-party payors as well as Medcare, Medi-cal, Medicaid, Triwest, veterans etc. Also obtaining authorizations for all HMO insurances, auditing patient reports for accuarcy, updating patient’s demographics, submitting, correcting claims and preparing appeal letters. Posting payments, credits and adjustments, changing test codes and CPT codes. Worked on Special projects given by Director, worked all billing work Queues. Worked with all commercial insurances HMOS, PPOs, third-party payers, Medicare, Medicaid, Medical. Systems that I worked with there were Xifin, CIS, Atlas also have knowledge of the use of ICD-9CM, CPT, HCPCS Level II codes and modifiers.

Pacific Urology

12/2010-02/2012

Medical Biller/Receptionist

Worked directly with patients, checked in patients as well as out, scheduled appointments for New patients and Established patients scheduled surgery appointments and follow-up appointments. Verified insurances collected Co-insurance and Co-payments, also worked with all commercial insurance BC, BS, Cigna, Aetna and all third-party payors. Worked claims, corrected claims, submitted appeals, also submitted prescriptions via electronic and by phone. Updated patient insurances and demographics per patient request, answering phones, working daily voicemails. Knowledge of the use of CMS 1500 and UB-04 forms. Systems used there were Cortex system. Overall knowledge of the use of ICD-9CM, CPT, HCPCS Level II codes and Modifiers.

Advanced MRI of Beverly Hills

10/2010-11/30/2010

Collections Specialist

Patient Customer Service, answering phones, verifying insurances, auditing claims, correcting claims, worked all Collections accounts all old A/R, submitting appeals and worked correspondence. Worked with all commercial insurances BC, BS, Cigna, Aetna, all third-party insurances, HMOs, Medicare, Medicaid, and Medical. Knowledgeable with UB-04 and CMS 1500 forms. Also have the knowledge of the use of ICD-9CM, CPT, HCPCS Level II codes and the use of Modifiers, .Systems used there were CSI, Tini Term etc.

Education

AAPC- Certified Professional Coder. 4/2014-5/2015

Everest College- Billing and Coding Specialist. 2/2010-9/2010

SCROC- Medical terminology and Coding. 3/2006-6/2006

SCROC- Microsoft Office Word. 2/2001-7/2001