AR Specialist with experience supporting multiple physician group in a busy medical billing office. Expertise includes verifying insurance coverage, follow up on third party claims, refiling HCFA claims electronically, pre-collections experience and excellent customer service experience.
Maintains strict confidentiality
Knowledge of HMOs, Medicare and Medi-Cal
OB-GYN, anesthesia, radiology, emergency room physicians and primary care
Managed care contract knowledge
Team player with positive attitude
Exercises good judgment
AR Specialist Escondido, CACalifornia Health Medical Billing/Nov 2016 to Current
Thoroughly investigated past due invoices and minimized number of unpaid accounts for two medical groups, but always willing to help other employees with any problems that arise with their own work.
Strictly followed all federal and state guidelines for release of information
Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.
Senior Recon Specialist Greeley, COBanner Healthcare System/Oct 2014 to Feb 2016
Meticulously tracked and resolved underpayments.
Submitted refund requests for claims paid in error. Performed quality control of the data entry system to verify that claims and payments were posted correctly. Responsible for clients in the following states: Arizona, Colorado, Wyoming, and Nebraska. Reviewed contracts to ensure proper payments were made for each payer.
Billing Manager San Diego, CAXifin Inc/Jan 2011 to Jun 2014Managed a production team of 12 employees. Ensured that month end closing was on time. Billed all lab claims with attached lab slips which had the appropriate CPT codes and ICD-9 or ICD-10 codes. Monitored to make sure all required claims documentation including referrals, treatment plans or other required correspondence were attached to reduce incidence of denials.
Billing Manager Cerritos, CAMarina Medical Billing Service/Mar 1999 to Feb 2010
Demonstrated analytical and problem-solving ability by addressing barriers to receiving and validating accurate billing information. Carefully reviewed medical records for accuracy and completion as required by insurance companies. Monthly audits to ensure every employee strictly followed all federal and state guidelines for release of information.
Monitored shared email in-boxes and ensured inquiries were addressed.
Interviewed possible new staff and if hired, trained and set up a shadow system to allow new employees to watch seasoned employees preform the same job they were hired for.
Education and Training
Medical billingSouthern California College of Medical and Dental CareersAnaheim, Ca, Untied States