Customer Service Medical Billing
Resume:
Michelle Vigil/Paredes
Westminster, CO ***** ***************@*****.***
Summary
To acquire a permanent position with a reputable company and establish myself as a professional who will actively contribute to company goals through knowledge, ability and dedication. Education
Diploma in Health
Heritage College of Health Careers - Denver, CO May 1994 to September 1995 Skills
● Typing 10 key explanation of benefits coding medical billing accounts payable accounts receivable customer service scheduling insurance contracts (10+ years)
● Medical Billing (10+ years)
● ICD-10 (10+ years)
● CPT coding (10+ years)
● Medical collection (10+ years)
● ICD coding (10+ years)
● Anatomy knowledge (10+ years)
● Medical records (5 years)
● Medicare (10+ years)
● HCPCS (10+ years)
● HIPAA (10+ years)
● ICD-9
● QuickBooks
Certifications and Licenses
Medical Coding Certification
May 1998 to Present
Professional Experience
PharMerica-Longmont, CO Nov 2023 to April 2024
Medical Claims Processor/AP/AR
● Processed and reviewed claims with accuracy and efficiency, ensuring adherence to organizational guidelines and resolving issues related to EOBs, copays, and patient accounts.
● Provided remote customer support to patients, addressing inquiries and resolving issues related to insurance claims, copays, and billing discrepancies in a timely manner.
● Facilitated payment resolution by coordinating with AP/AR teams, insurance providers, and patients, ensuring accurate account reconciliation and improved customer satisfaction.
● Guided patients through the claims process, offering detailed explanations of EOBs, coverage details, and next steps to expedite resolution.
Big Bear Motors-Golden, CO Sept 2022 to Nov 2023
Customer Service Coordinator
Responsibilities Included:
● Worked with Sales Associates to ensure consistency and excellent customer service on the sales floor.
● Instrumental on training staff on telephone etiquette and assuring telephone calls were answered or returned in a timely and friendly manner.
● Responsible for hiring and managing the hiring process including recruiting to retain valuable personnel.
● Picked up and dropped off cars for auctions and rental car agreements. Department of Veterans Affairs-Denver, CO June 2006 to Aug 2022 Customer Service Coordinator/Claims Processing Specialist Responsibilities Included:
● Performed customer reviews by examining medical records, community care authorizations, community payment records and historical tracking of submitted health care claims.
● Communications to Veterans to assist in filing claims and inform them of what information is needed to support their claims.
● Conducted comprehensive reviews of medical records, community care authorizations, and payment records to validate health care claims, ensuring accuracy and compliance.
● Identified the elements of the clinical or administrative practices that contribute to and create an atmosphere for patient complaints and recommended changes that will reduce or eliminate complaints.
● Investigate complaints and initiate actions, appeals or changes to rectify the situation and report this corrective measure to the parties involved.
● Investigated and resolved patient complaints, initiated corrective actions or appeals, and communicated outcomes to all involved parties to maintain service excellence.
● Gather, analyze and prepare information while applying sound judgement when responding to inquiries.
● Contribute to vendor recovery while completing complex requests in a timely and efficient manner.
● Provide consultation services to Veterans, vendors, congressional offices, veteran service organizations, staff and other stakeholders to facilitate performance improvement.
● Provided expert consultation to Veterans, vendors, congressional offices, and stakeholders, offering guidance to streamline claims processing and improve overall performance.
● Worked with appropriate departments to ensure fairness on policies and procedures to meet the needs of the diverse populations served.
Columbia HealthOne-Denver, CO May 1996 to Nov 2006 Medical Billing Coordinator
Responsibilities Included:
● Processing billing transactions for Medicare and Medicaid of Colorado.
● Billed private insurance companies on behalf of our clients.
● Researched and resolved instances leading to insurance under payments on behalf of our clients.
● Researched and resolved denials by insurance companies as well as past due accounts due to customer insurance issues.
● Responded to patients inquires.
● Resolved and reviewed past due credit balances.
● Ensured insurance claims complied with company contracts.
● Trained and monitored new employee progress on internal computer system, Meditec.
● Contracted and organized training for the Admission Department at Rose Medical Center.
● Counseled patients on bill alternatives as well as referred clients to various contacts to resolve payment issues.
● Conducted debt management seminars to clients.
● Counseled needy clients on services provided by our organization as well as external agencies that could provide services.
● Work in admissions at Rose medical
DNA Medical Software-Denver, CO Jan 2003 to Nov 2003 Medical Billing Representative
Responsibilities Included:
● Billed appropriate offices for medical payments.
● Followed up with these offices to ensure payment.
● Worked with various agencies and billing processes such as collections and customer service.
● Coordinated self-pay and adjustments on client accounts.
● Worked daily with the internal office and system and processed transactions through that system.
● Served as the Assistant to the Vice President as well as the President to resolve complaints and troubleshoot programs on their behalf.
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