Angelica M. Cardona

**** *. **** **

Weslaco, TX 78596

956-***-****

adwhi1@r.postjobfree.com

Objective: Seeking a position with a growing company that will expand my knowledge and abilities.

Experience: Thurmond Eye Associates Weslaco, TX

Insurance / Data Entry Clerk 1/2015 – Current

Daily Payments and Charge / End-of-Month

oPost payments daily based on bank deposits to both clinic and optical

oBalance payments, adjustments, and write offs before being able to continue posting the following day

oBalance end-of-month for Optical charges, payments, adjustments, and write-offs.

Insurance verification

oVerify insurances

oVerify surgical benefits

oObtain insurance authorization for surgeries

oObtain the insurance allowable

oEstimate the amount that will need to be collected from the patient for their surgical procedures from their benefit information

Staff phone calls

oInsurances and Insurance benefits

oPatient balances

Patient phone calls

oAnswer questions pertaining to balances

oTake payments over the phone

oHandle patient disputes if claims were sent to wrong insurance

Have to correct the insurance on the claim and have the original claim reprocessed

Shah Eye Center Mission, TX

Collector / Biller 11/2013 – 12/2014

Correspondence

oComplete correspondence issues and appeals for all insurance payers

oInsurance refund request

Dispute refund if insurance did not pay allowable

Complete refund request

Statements

oReview statements

oMail out the statements

Insurance verification

oVerify insurances

oVerify surgical benefits

oObtain insurance authorization for surgeries

oObtain the insurance allowable

oEstimate the amount that will need to be collected from the patient for their surgical procedures from their benefit information

Staff phone calls

oInsurances and Insurance benefits

oPatient balances

Patient phone calls

oAnswer questions pertaining to balances

oTake payments over the phone

oHandle patient disputes if claims were sent to wrong insurance

Have to correct the insurance on the claim and have the original claim reprocessed

Collections

oCoordinate with the collection agency

oSend information to the collection agency so they can track the patients and collect revenue

oCall collection agency when the patient disputes the amount they were sent to collections for and provide collection agency with correct amounts when applicable.

Batches

oTrack batches received from Finance Dept on a tracking log

oBreak down credit card charges for main facility (check-in/optical/lasik/billing)

oVerify the credit card amounts match on the daily audit reports to the daily deposit credit card amount.

oBox batches by facility and dates of service

oBox payment batches by date the payment was posted

Box correspondence by date they have been worked

Chatterbox Therapy Mission, TX

Biller/Scheduler 7/2012 – 1/2013

Prepare and submit clean claims to various insurance companies either electronically or by paper.

Answer questions from patients, physician staff and insurance companies.

Identify and resolve patient billing complaints.

Evaluate patient’s financial status and establish budget payment plans. Follow and report status of delinquent accounts.

Contact patients to reschedule or cancel appointments

Communicate to various home health agencies if therapist and/or patient cancel or reschedule therapy sessions.

Verify patient’s insurance on a monthly basis to assure proper authorization for treatment was obtained.

Assisted in the credentialing of therapist with CAQH and other insurance companies for proper in-network processing of claims.

Sambritt Home Health McAllen, TX

Medical Records / Therapy Scheduler 3/2012 – 7/2012

Contact patients to reschedule or cancel appointments

Provide weekly schedule to therapist for patients that needed to be seen for re-evaluations or discharges.

Schedule patients properly when patient was seen for more than one discipline.

File documentation as needed in each patient’s binder for each certification.

Med-Fast Management Services Pharr, TX

Medical Billing Specialist 12/2008 – 3/2012

Summary of Duties: Responsible for collecting, posting and managing various accounts for physicians with different specialties.

Prepare and submit clean claims to various insurance companies either electronically or by paper.

Answer questions from patients, physician staff and insurance companies.

Identify and resolve patient billing complaints.

Prepare, review and send patient statements

Evaluate patient’s financial status and establish budget payment plans. Follow and report status of delinquent accounts.

Review accounts for possible assignment and make recommendations to the physician / office manager, also prepare information for the collection agency.

Perform various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.

Post payments from insurance companies and prepare daily deposit reports for monthly reconciliations.

Review explanation of benefits from insurance for denied claims. Correct and resubmitted corrected claim if needed.

Used Medisoft, Cerner, and Waiting Room Solutions.

Smith Disposal Facility Edinburg, TX

Administrator 10/2003 to 2/2008

Assisted owner in planning and execution of requested and approved amendments or extensions of contracts with major oil companies.

Executed daily operations of A/R and A/P using Quickbooks.

Supervised 6 employees, scheduled work hours, resolved conflicts, determined salaries.

Maintained financial records and produced quarterly reports for Railroad Commission of Texas.

Expedited communication between upper level management and general personnel.

Convergy's McAllen, TX

Customer Relations 1/2001 to 2/2003

Interviewed applicants for cable television system service.

Reviewed complaints concerning billing and service rendered, resolving most complaints.

Discussed cable television equipment operation with customers over telephone to explain equipment usage and to troubleshoot equipment problems.

Education: KAPLAN McAllen, TX

Medical Office Specialist Certification January 2009

PSJA North High School Pharr, TX

HS Diploma 1997

References: Available upon request

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