Claims Processor Medical Billing

EXPERIENCE

Marjorie Aguirre

408-***-**** ********.*******@*****.*** San Jose, Ca 95136

Dedicated worker with excellent communication, time management and computer skills. Aiming to leverage my abilities to successfully ll the vacancy at your company. Frequently praised as hardworking by my peers, I can be relied upon to help your company achieve its goals.

CLAIMS PROCESSOR

Sutter Shared Services

Roseville, CA

January 2018 - November 2020

As a remote team member with the Revenue Cycle Solutions team i worked on a variety of medical claims and worked with insurance companies to have claims paid timely.

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• Performed audits on accounts with associated correction regarding billing,payments,and adjustments errors.

• Properly documented functions in patients accounts notes.

• Special projects and researched for payments and outstanding inventory.

• Requested authorizations to obtain payment vs write o f. DENIAL MANAGEMENT /FERTILITY

Palo Alto Medical Foundation

Palo Alto, CA

January 2015 - November 2018

• Posted medical insurance billings.

• Scanned patients' health records into electronic formats. Entered data, such as demographic characteristics, history and extent of disease, diagnostic procedures and treatment into computer.

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• Reviewed and posted daily payments.

• Provided product information and resolved concerns to assist customers. OFF SITE REGISTRATION /CLAIM EDITS

Palo Alto Medical Foundation

February 2012 - January 2015

• Epic Work Queues/Claim Edits

• Correcting/updating Insurance information

• Updating all Demographics

• Contacting Patients

• Follow up with Insurance

• Communicated immediately with providers to clarify incomplete or unclear documentation.

• Entered billing information into accounting software systems.

• Contacted and worked with patients to resolve insurance-related billing issues.

• Performed claims research, appeals and related follow-up using medical systems and software.

• Assisted with answering telephone to provide requested billing information.

• Prepared and reviewed claims for submission, resolving upfront claims edits and errors.

• Veri ed accuracy of billing data and revised any errors. EDUCATION

SKILLS

LANGUAGES

NEW PATIENT REGISTRATION

Palo Alto Medical Foundation

Palo Alto, CA

August 2008 - February 2012

• Maintained medical records, technical library and correspondence les. Operated o ce equipment, such as voice mail messaging systems and used word processing, spreadsheet and other software applications to prepare reports, invoices, nancial statements, letters, case histories and medical records.

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• Transmitted correspondence and medical records by mail, e-mail and fax.

• Completed documents, case histories and forms, such as intake and insurance forms.

• Answered telephones and directed calls to appropriate sta f.

• Completed insurance or other claim forms.

CERTIFICATION IN CLINICAL MEDICAL ASSISTING

Bryman College, San Jose, CA

Jan 2008

• Past Due Balance Management • Financial Assistance

• Medical History Recording • Eligibility Determinations

• Health Record Index Maintenance • Medical Billing Processing

• Claim Amount Calculations • Insurance Billing

• Patient Medical Records Maintenance • O ce Health Records Preparation

• Bene ts Veri cations • Billing Statements

• Filing Systems • Provider Enrollment

• Insurance Carrier Applications • Insurance Claim Forms Review

• Insurance Claims and Denial Processes • Adjustment Posting

• Payment Plans • Basic Medical Terminology

• Patient File Updates • Medical Records Research

• Account Updates

Spanish

Fluent

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