Bilingual (English / Spanish) Medical Biller / Collector eager to contribute extensive

administrative, leadership and communication skills toward supporting a dynamic employer in optimizing bottom-line performance.

 

 

         Industrious self-starter and multi-tasker with excellent knowledge of medical terminology.

         Strong blend of planning, scheduling, prioritization, and documentation skills.

         Significant experience in supervising and directing administrative and medical billing staff.

         Highly respected for attention to detail and deadlines, computer skills, integrity, sound judgment, and a team player work approach.     

         Methodical problem solver; able to create and execute innovative solutions to meet defined business goals and needs.  

         Advanced knowledge of all major carriers such as Blue Cross, Blue Shield, Aetna, Cigna, United Healthcare, Coastal TPA, TRICARE, Medi-cal,  Workers Compensation, auto insurance, and all non-contracted insurance.

         Considerable ability to process a high volume of work without sacrificing quality, and continuously seek out new ways to streamline administrative processes. 

         Type 45+ words per minute and proficient in using 10-key calculator by touch.

 

 

Salinas Valley Memorial Hospital, Salinas, CA, 2007 to Present

Medical Billing & Collections

         Meticulously review all inpatient and outpatient accounts from previous day to insure patients insurance was registered and account was coded properly.

         Verify patient insurance information prior to surgery or visits.

         Demonstrate exemplary organizational skills in communicating with up to 20 insurance companies/programs to diligently follow-up on claims exceeding $5,000 and expedite processing and payment.

         Efficiently bill outpatient, inpatient and secondary claims and scrutinize coding before electronic or hard copy submission.

         Apply sharp multi-tasking expertise toward handling daily incoming mail and $0 payment EOBs (Estimation of Benefits), correcting incorrect claims, managing appeals, and itemizing statements of charges for re-processing of claims.

         Contact patients when insurance organization requires additional information.

         Collaborate with all major insurance organizations including Blue Cross, Blue Shield, Coastal TPA, Aetna, Cigna, United Healthcare, Tricare, auto insurance and Worker s Compensation to facilitate payment from insurance in less than 45 business days.

         Identify and report overpaid claims and send refund request.

 

Continued ►

 

 

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Professional Experience continued

 

Monterey Spine & Joint, Monterey, CA, 2005 to 2007

Medical Billing Supervisor

         Spearheaded medical billing operations encompassing accounts receivable, posting of charges, patient and insurance payments, bank deposits, and internal processing of electronic/paper claims submitted for reimbursement.

         Applied annual updates for Medicare fee schedule and major carriers RVUs and global days.

         Generated monthly statements every 30 days for remaining account balances and receivables.

         Conducted daily collection calls to patients and insurance firms having outstanding balances.

         Tracked emergency room visits and procedures to confirm posting by physicians of Emergency Acute program at Community Hospital of Monterey.

         Monitored and replenished critical supplies as needed such as HCFA/statement paper envelopes, ink for postage meter and ICD-9 and CPT books.

         Directed, supervised and mentored two medical billers, reliably overseeing monthly financial reports and aging of accounts to facilitate continuous cash flow and reimbursement.

 

Doctors on Duty, Monterey, CA, 2004 to 2005

Front Office Supervisor

• Seamlessly orchestrated full spectrum of administrative operations such as opening and closing clinic, scheduling appointments, registering patients, managing/copying/updating medical records, and supervising efforts of three receptionists.
• Accurately inputted patient data following service rendered (i.e. diagnosis, procedures).
• Received and processed co-pays, self-pay payments and walk-in payments, performed all bank deposits, and administered Workers Compensation and TRICARE referrals and authorizations.
• Appreciated by doctors, x-ray technicians, and medical assistants for fluency in Spanish and ability to translate.
• Resourcefully cross-referenced receptionists batches to validate billing data.
• Coordinated all staff payroll by entering doctors hours in spreadsheet and sending to corporate office.

 

MedTech, Salinas, CA, 2004

Medical Biller (Intern)

• Successfully completed internship while gaining invaluable experience in medical insurance billing, providing top-notch customer service, completing HCFA forms, and utilizing Medisoft computer application.

 

Medical Biller/Coder Diploma, Central Coast College, Salinas, CA, 2004