(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
Logical and efficient Medical Coder and Billing Professional with skills in abstracting information and assigning codes and procedures related to medicine, surgery, radiology and pathology with experience of complete billing cycle. Analytical skills necessary to interpret and apply knowledge. *Well-organized, able to manage time and priorities in multi-task environments. Exceptional interpersonal communication skills - fosters effective working relationships with clients, coworkers, and supervisors. *Demonstrated ability to liaise with insurance companies. *Well versed with ICD10/CPT /HCPCS coding terminology, anatomical and physiology *Thorough understanding of computerized billing, ability to process insurance claims, authorizations and complete life cycle of an insurance claim and posting to patients accounts. * Ability to work with limited supervision accurately and efficiently at all times, including those of high processing volume. *Ability to multi-task and manage time efficiently under the pressure of deadlines. *Highly motivated to work in team-oriented and collaborative environment. Sensitivity to the confidential nature of the data and proprietary company information. In depth knowledge of medical records, ethics and HIPPA
  • Medical Billing
  • Medical Coding
  • Payment Posting
  • Patient Services ICD-10-CM
  • CPT
  • ICD-9-CM
  • Scheduling
  • Insurance Verification CMS 1500
  • CMS 1450 (UB-04)
  • EOB / COB
  • Collections Government Payers
  • Medicare
  • Medicaid
  • Tricare
  • Third- Party Payers
  • Claims Documentation
  • Electronic Medical Records (EMR / EHR)
  • Greenway Connect, Practice Fusion, Advance MD
  • Co-Payments and Deductibles
  • Medical Terminology
  • Anatomy & Physiology
  • HIPAA Compliance
  • Managed Care (HMO, PPO, and POS)
  • Worker's Compensation
  • Office Management
  • Insurance Claim Processing
  • Insurance Billing Procedures
  • MS Word / Office / Excel
  • Medical Office Procedures
  • Computer Skills
  • Data Entry
  • 10-Key Skills, HEDIS
Education and Training
Ultimate Medical Academy Tampa, FL Expected in 07/2016 : Medical Billing and Coding - GPA : Medical Billing and Coding 4.00
Electronic Data Processing College San Juan, PR Expected in Bachelor Degree : Computer Programming - GPA : Computer Programming
Electronic Data Processing College San Juan, PR Expected in Associate Degree : Business Administration - GPA : Business Administration
Vallen - Biller and Coder Specialist
Morrison, TN, 11/2016 - 08/2017
  • Conducts physician chart audits to identify incorrect coding, prepares reports of findings and any compliance issues.
  • Communicate with physicians and center administrators regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation.
  • Posting charges, following up on outstanding claims, receiving and posting insurance and patients payments, preparing and filing appeals, account reconciliation and researching account balances.
  • Work denied claims.
  • Read and understand an EOB and remits.
  • Calling Insurance companies to inquire about the denials.
  • Worked with Practice Fusion and Advanced MD.
Vallen - Customer Service Representative
Moses Lake, WA, 09/2016 - 11/2016
  • Performing Investigation, analysis and follow-up member's account for Freedom and Optimum health plans.
  • Answering member's questions about health insurance plan, copayments and deductibles,.
  • EOB-EOP, Enrollment for 2017.
  • Explaining Claims and Authorizations.
  • OTC purchases.
  • Verify HIPAA forms, POA verifications.
  • Working with IKA program, IMG program, DMS, CRM Medicare applications.
  • HEDIS.
  • Verifying the correct ICD-10 and CPT codes was posted in the 1500 form.
Dr. Julia Barriga, Pediatrician EXTERNSHIP PRACTICE - Reviewed EOB/EOP
City, STATE, 08/2016 - 09/2016
  • Update monthly and Daily activities in the Super bills Reconciliation.
  • Insurance verifications for different insurance plans.
Citigroup - Customer Service Representative
City, STATE, 04/2003 - 08/2013
  • Performed investigation, analysis and follow-up for collection of overdue accounts and customer service.
  • Secured collection of accounts, negotiated payment arrangements, and accepted payments.
  • Answered account inquiries and ensured accuracy of information.
  • Complied with Federal and state laws and provisions.
  • Answered members questions about their Home Depot Credit Card.
Bilingual - Fluent in English and Spanish
Activities and Honors
▪ ▪ ▪ National CPC-A Certification ▪ ▪ ▪ 
10-Key, account reconciliation, Anatomy, Billing, CMS, CPT, Credit, CRM, customer service, Data Entry, Documentation, Electronic Medical Records, Fluent in English, filing, forms, Government, ICD-10, ICD-9, Insurance, Medical Billing, Medical Coding, Medical Terminology, Excel, Office, MS Word, Office Management, Physiology, policies, POS, coding, Read, receiving, researching, Scheduling, Spanish

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Resume Overview

School Attended

  • Ultimate Medical Academy
  • Electronic Data Processing College
  • Electronic Data Processing College

Job Titles Held:

  • Biller and Coder Specialist
  • Customer Service Representative
  • Reviewed EOB/EOP
  • Customer Service Representative


  • Bachelor Degree
  • Associate Degree

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