Behavioral Health Billing Specialist
Resume:
Barbara Urena-Flores
Oxnard, CA *****
*****.*******@*****.*** - 805-***-****
WORK EXPERIENCE
Ventura County Medical Center
Medical Billing Specialist I, Ventura, Ca 5/29/23- current
Follow up on Facility & Professional claims.
Software worked with Huron and Cerner and all payer websites.
Worked high dollar to low dollar accounts.
Reviewed credits, payments & adjustments.
Processed refund requests from health plans as well as patients.
Customer services are provided for our patients and all types of payers.
Active Steps LLC, Billing Manager, Ventura, Ca 2/2021 – 3/2022
Billing for Behavioral Health outpatient.
Received referrals for Medi-cal Insurance, verified eligibility for behavioral health
Worked for San Diego, Ventura, Inland Empire, San Bernardino & Orange County.
Worked with Accupoint and Measure Software, clearing house worked with Ability and Office Ally.
Invoicing for our School District billing for Ventura of Education, Fullerton School District, Irvine School District.
Worked with contracting and credentialing for our Commercial and Medi-cal Insurance.
Created all billing training materials
Account receivables, denials, appeals.
Conejo Valley Practice Mng.
Billing for Pediatric and Behavioral Health Newbury Park, Ca 91320 5/2020-2/2021
Verify Eligibility for multiple Insurance.
Bill with 1500cms forms.
Worked with Lytec software, Office Ally clearing house.
Posted copays.
Cedars-Sinai Medical Ctr.
Billing and Collections Specialist Patient Financial Services Los Angeles, ca – 4/5/2016 – 5/2020
●Verify eligibility for multiple insurance on web or over the phone for Private insurance, Manage care. Medi-cal website. & Medicare HMO.
●Bill commercial insurance, manage care, Medicare crossover insurance. Follow up for commercial, manage care.
●Bill with UB04 claims, submitting appeals for retro authorization, underpayments, medically necessity. To all IPA’s and health plans as well as capitated facilities.
●Working off Emdeon for electronic billing as well as paper claims on Epic.
●Collections for all types of insurance.
●Authorizations & retro authorization request as well.
Sutherland Healthcare Solutions Billing Specialist/ Commercial Insurance Torrance, CA – 7/2013 to 3/2016
●Verify eligibility for multiple insurance on web or over the phone for Medi-cal & Private insurance, Medicare
& Medicare HMO, as well as training new employees and creating manuals for billing.
●Bill commercial insurance, manage care, Medi-cal, Medicare cross over insurance. Follow up for commercial and Managed care.
●Work from an excel ATB spreadsheet assisting lead on organizing spreed sheets for others. Assisting manager with client urgent requests.
●Bill with UB4 claims and 1500 claims, as well as clerical duties on a daily bases.
●Epremis billing UB04 & 1500 claims for Out Patient facilities.
●Patient discrepancies.
●Correspondence.
Gordon, Edelstein, Krepack, Felton & Goldstein Law Firm Receptionist / Floater/Legal Secretary 7/2003 TO 7/2013
Insurance Company, Defense Attorney's & Doctors - Los Angeles, CA - July 2003 to July 2013
Receptionist / Floater/Legal Secretary
•Handled incoming traffic for both walk-ins and over the phone and re-directed to appropriate party(ies)
•Send out Notice of Hearing for our clients, Insurance Company, Defense Attorney's & Doctors
•Serve as a first contact assisted in initial screening for the firm call consisted of Union Representatives & Potential Clients.
•Create and managed hard/soft copy files for firm's clients.
Clifford L. Corman, MD Inc Medical Biller
Insurance Company, Defense Attorney's & Doctors - Los Alamitos, CA - April 2013 to April 2013 CA
Clifford L. Corman, MD Inc.
Medical Billing
•Handled incoming traffic for phone calls.
•Serve as a first contact assisted in initial screening for the medical office
•Calling for insurance benefits
•Posting payments & sending out claims.
EDUCATION
Medical Coding
Devry University
May 2022 - current
Everest College - Gardena, CA
May 2012 to January 2013
Diploma in Billing and Coding
Parkridge Private School - Long Beach, CA
May 2012
UEI College - Huntington Park, CA
November 2002 to June 2003
CERTIFICATIONS
Diploma in Medical Assistant.
Contact this candidate