Medical Billing Front Desk
Resume:
Rocio Valle
Contact
National City, CA 91950
Email: ************@*****.***
Objective
To enhance my educational and professional skills in a stable and dynamic workplace and work with an organization that offers Integrity, professionalism, and the opportunity for upward mobility. Key Skills
• Helpdesk Support
• Microsoft Windows
and Office
• Customer Service
Support
• Problem-Solving
• Communication
• Online Chat
Support
• Team Leadership
• Time Management
• Decision Making
• Accounting
• Admissions
Process
• Software
Evaluation
• Database
Management
Work Experience
3/2021 – 5/2023
Information Technology (IT) Specialist I
VETERANS HOME OF CALIFORNIA CHULA VISTA/INFORMATION SERVICES DIVISION 700 E. NAPLES CT., CV, CA
As part of Project Management under the ISD/CalVet Health Informatics Program team, as a health informatics specialist, focus on how health information is captured, transmitted and used in a variety of health care settings. Provide technical and an interdisciplinary approach that blends information technology with communication and health care. Knowledge of system software and system functionality for the Electronic Health Record (EHR) for Long- Term Care Facility and adhere to California Military & Veterans Code and government laws and regulations. Responsibilities;
• Medical Billing
• Admissions Process
• Lead Financial Tester
• To-Be & As-Is Business Processes
• Performed Classroom Training and one-on-one Training 6/2020 - 3/2021
Information Technology Associate (ITA)
VETERANS HOME OF CALIFORNIA – CHULA VISTA/INFORMATION SERVICES DIVISION 700 E. NAPLES CT., CV, CA
As part of the CalVet Health Informatics Program, involved in several project assignments, developing training objectives, creating training guides, creating and evaluating training plans, for staff at the Long- Term Care Facility. Responsibilities;
• Develop Training Guides
• Modify existing Business Processes
• Create & Support Access Databases
• Create & Support Share Point End User Platform
• Create Visio Diagrams
10/2017 - 6/2020
Associate Governmental Program Analyst
VETERANS HOME OF CALIFORNIA – CHULA VISTA/INFORMATION SERVICES DIVISION 700 E. NAPLES CT., CV, CA
As part of the CalVet Health Informatics Program team provided technical expert knowledge on system software and system functionality for the Electronic Health Record (EHR). This includes but not limited to; medical billing, reimbursements, admissions, rehab and accounting processes. Responsibilities;
• Change Request Analysis
• Validate System Enhancements & Behavior
• Work with Clinical Staff (Physicians, Nursing, Social Work etc.)
• Participated in Office of Statewide Health Planning and Development (OSHPD)
• Participated in the Merit-based Incentive Payment System
(MIPS)
11/2016 – 10/2017
Staff Services Manager I
VETERANS HOME OF CALIFORNIA – CHULA VISTA 700 E. NAPLES CT., CV, CA As the Staff Service Manager I, in a Long-Term Care environment; prepared fiscal allocation plans for the Veterans Home as well as on- going coordination of matters relating to the financial management of Personal Services and Operating Expenses & Equipment. Managed and supervised the functions of the Finance Office and provide guidance, training and support for the staff in the Finance Office. Responsibilities;
• Supervised 8 staff members and 1 volunteer
• Supervised Admissions Department
• Supervised Banking/Accounting Department
• Supervised Mailroom
• Supervised Front Desk Lobby
• Supervised Patient Benefits Department
• Supervised Veterans Representative
• Work with Clinical Staff (Physicians, Nursing, Social Work etc.)
• Interacted with DHS surveyors, Medi-Cal auditors etc.
• Meet with the Fiduciaries
• Meet with Ombudsman
• Meet with Social Workers
• Meet with Law Enforcement
• Meet with Attorneys
1/2015 – 11/2016
Associate Governmental Program Analyst (EHR)
VETERANS HOME OF CALIFORNIA – INFORMATION SERVICES DIVISION 700 E. NAPLES CT., CV, CA
As part of the CalVet Health Informatics Program team provided support to Information Technology related projects as subject matter expert in the health, nursing, medical, rehab, financial. Participated in various aspects of the Business Technology Management including system development, business process modeling, and business analysis. Responsibilities;
• Business Process Reengineering
• Resolve User/Client Issues
• Train Via Teams Meeting and/or One-on-one
• Support 8 CalVet Homes Training
• Professional Billing
1/2014 – 1/2015
Staff Services Analyst
VETERANS HOME OF CALIFORNIA – INFORMATION SERVICES DIVISION 700 E. NAPLES CT., CV, CA
As part of the CalVet Health Informatics Program team, I was the lead for User Acceptance Testing of the functionality of systems. Analyzed and assess existing business systems, processes, procedures, and functional requirements. Developed future processes design for Long-Term care and acute levels of care. Prioritized problem resolutions to ensure system requirements were met. Responsibilities;
• Adhere to Policy & Procedures
• Medical Budgets
• Medical Projections
• Medical Contracts
• Medical Expenditures
• Verified Healthcare Eligibility
11/2003 – 1/2014
Patient Benefits & Insurance Officer I
VETERANS HOME OF CALIFORNIA – CHULA VISTA 700 E. NAPLES CT., CV, CA As part of the Finance Office and Patient Benefits Department, provided expert knowledge in the area of medical billing and reimbursements. Duties included but not limited to; performing various technical assignments of case work such as evaluation of medical programs, insurances, and claims eligibility. Assist Veterans and family members with applying for Medi-Cal, Medicare and other Healthcare coverages and benefits through the Federal VA. Generate electronic Medi-Cal TARs for Skilled billing, and review Letter of Agreement for payment. Implemented departmental policies to encourage the expansion of insurance and resources. Responsibilities;
• Adhere to Federal & State Regulations
• Verify eligibility with CMS and other insurances
• Apply for Medi-Cal in behalf of the Veteran
• Meet with Hospice Provider
• Professional Billing
• Ambulatory Care Billing
• Apply for Social Security Benefits in behalf of the Veteran
• Negotiate Medicare Rates
• Create and bill e-TARs through Medi-Cal
• Meet with the Fiduciaries
• Meet with Ombudsman
• Meet with Social Workers
• Meet with Law Enforcement
• Meet with Attorneys
6/2000 – 10/2003
Management Services Technician
VETERANS HOME OF CALIFORNIA - CHULA VISTA 700 E. NAPLES CT., CV, CA As part of the Medical Department in a Long-Term Care Facility, and under the Chief Medical Officer, performed the duties in the area of medical budget and medical reimbursements. Performed continuous budgetary reviews and maintained veterans’ homes medical appropriations through review and expenditures analysis. Responsibilities;
• Tracked Medical Contracts
• Projected future expenditures for Medical Contracts
• Set Medical Appointments in behalf of the Veteran
• Entered various type of Physician Charges into EHR system for Reimbursement
• Negotiate Medicare Rates
• Verified Eligibility
• Created tracking database for Medical Appointments Education & Professional Training
• GED
• Project Management Training
• LinkedIn Learning
• Skelly Officer Training
• Equal Employment Opportunity Training
• Medicare Boot camp Training
• Contract Training
• Labor Relations Training
• Supervisory Part I Training
• Supervisory Part II Training
• Conflict Resolution Training
• Ethics Training
• Teller Training Institute
• Pace E-Learning Training
References
Available Upon Request
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