Angelica Ibarra

*** *********** ***** * FRANKLIN, TN 37067* PHONE (615) 294 - 2404

Objective

To secure a position that will offer a substantial challenge and the opportunity to utilize my communication skills, strong work ethics and detail oriented. And where my growth and proficiency will have valuable application.

Experience

06/2009 ¬– Present Sentry Healthcare Services (HMS Healthcare Management Systerms)

Contract Management Representative

• Provide the CFO and /or other managers with payor log reports as needed for financial reporting, auditing and cost reporting purposes.

• HMS knowledge such as billing, transaction posting, patient account maintenance and payor logging. Really detail-oriented.

• Review the Payor Log Balancing Report daily and correct any errors that are reported having to do with the payer reimbursement processes.

• Run the Billed/Paid Log Report daily to assure all payor transactions are correctly reflected in teh payor logs requiring good analytical skills.

• Review the Payor Log Exception Report daily and maintain logs and /or patient accounts as needed, including financial classes, payor plans, revenue codes, transaction codes, log descriptions, ect.

• Work the Payor Log Reconciliation Reports at least monthly prior to month end.

05/2008 – 05/2009 Centennial Pediatric

Patient Fiancial Services for AmeriGroup

• Review all EOB’s for AmeriGroup

• Follow up with any problems that has to do with AmeriGroup, like CPT codes, NPI errors, Newborn claims, Rejections. I handle all of AmeriGroup insurance company and I follow up with meetings, spread sheets and the AmeriGroup contact.

• Mail letters out for claims that denied for COB, to the guarantor.

• Follow up on claims that money was recoup, and request for money to be recoup.

• Follow up on claims that rejected electronic (EDI)

• Answer all Spanish phone call’s from patients and inform them about there accounts.

• Translated Clinic’s documents from English to Spanish.

10/2007 – 02/2008 HCA Physician Services

Account Representative

• Working with Core, OneSource & OnBase Thick.

• Working with CMS 1500 forms for Commercial, Medicaid & Medicare, making sure that the provider PIN, Group GIN, tax ID, & provider individual were all linked together for billing.

• Identified coding or billing problems from EOBs & worked to correct the errors in timely manner.

• Monitor insurance claims by running appropriate reports & contacting insurance companies to resolve claims that are not paid in a timely manner.

• Adjusted accounts, dropped claim to the secondary insurance or to the patient.

03/2005 – 10/2007 AIM/INGRAM/CRG Franklin, TN

Account Manager

• Worked with MediTech, ChartMaxx, Web form., Payer Facts, OnBase Thin & FACS.

• Worked with Excel Spreadsheets, Microsoft word, Outlook, Power Point.

• Printed and requested UB92, EOBs, Medical records, Itemized bills, & Implant invoices.

• Analyze and research under paid insurance claims per contract agreements. Also view over paid and interest payments.

• Corrected Ins information in MediTech if different then the EOB or the patient insurance card.

• Posted payments and moved money to the patient bucket, requested manual adjustments for claims with a bal of under $250.00 and with a balance of over $250.00.

• Follow up on all appeals and pending insurance claims.

• Maintain a daily production goal for appealed, worked and recovered claims.

07/2004 – 03/2005 MedSolutions, Inc Franklin , TN

Collector

• Worked with MCRS, ISAAC, CRM and QMACS systems.

• Follow up on all 30 days and older, for 9 hospitals in deferent states.

• Called Cigna to follow up with claims or used Cigna's web site.

• Requested Pre-Existing information from the provider.

• Requested EOBs to bill secondary insurance.

04/2003 – 04/2004 Kessler Rehabilitation Center Franklin, TN

Secondary Biller & Collector

• Requested EOBs to bill secondary insurance.

• Re-billed claims for workers compensation.

• Re-billed no-fault insurance.

• Called and emailed clinics to request medical records or patient documentation.

• Returned mail, and familiar with HCS system UB92 forms, & 1500 forms.

02/2002 – 04/2003 ARX Franklin , TN

Claim Analyst

• Analyze billing and reimbursement data.

• Responsible for receiving and assisting all Spanish-speaking customers.

• Insurance verification followed up with claims, to ensure the claim was received, & processed correctly according to contract.

• Documented all progress and resolution.

Education

1992 Monache High School Porterville , CA

Diploma, general education

2005 National College of business and Technology Nashville, TN

Billing & Coding, 2 semesters total of 8 classes

Languages

Bilingual, Spanish and English, both spoken and written.

Reference

Available upon request.

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