Alejandra Colmenares
Las Vegas,NV
Summary
Detail-focused professional in the financial documentation and management field, known for high productivity and efficient task completion. Specialize in accurate billing, proficient data entry, and effective account reconciliation. Excel at time management, problem-solving, and communication skills, ensuring seamless operational flow and client satisfaction.
Overview
1
1
Certification
13
13
years of professional experience
Work History
Medical Biller, Medical Front Desk
Epitomedical
02.2024 - Current
- Managed all payment processing, invoicing, and collections tasks.
- Maintained up-to-date knowledge of government regulations related to healthcare reimbursement policies and procedures.
- Generated reports to track payments due from insurance companies or other third-party payers.
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
- Collected, posted and managed patient account payments.
- Assisted with collection efforts as needed including contacting patients via phone, mail or email for collection of past due balances due to insurance denials or patient responsibility amounts owed.
- Submitted appeals using provider portals and phone communication.
- Applied HIPAA privacy and security regulations while handling patient information.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Submitted claims to insurance companies electronically or by mail.
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Performed daily audits on all bills submitted for accuracy and completeness.
- Quickly responded to staff and client inquiries regarding CPT codes.
- Documented and filed patient data and medical records.
- Set up patient charts and documented information in various company software.
- Maintained up-to-date knowledge of coding regulations and changes in reimbursement policies.
- Entered patient insurance, demographic and health information into software and confirmed records.
- Identified trends in denials and worked collaboratively with clinic staff to reduce denials.
- Verified accuracy of patient information and insurance data in billing system.
- Provided customer service support to patients regarding billing inquiries.
- Handled incoming calls and directed callers to appropriate department or employee.
- Utilized ICD-10, CPT, and HCPCS coding systems to process claims and billing.
- Resolved denied claims by researching payer requirements and preparing appeals.
- Processed corrections and adjustments as needed to ensure accurate payment from third party payers.
- Streamlined day-to-day office processes to meet long-term goals.
- Worked closely with physicians to obtain additional clinical information when needed for accurate coding assignments.
- Pulled patient records and transferred information to appropriate parties.
- Safeguarded medical records to maintain patient confidentiality.
- Reviewed medical records to meet insurance company requirements.
- Analyzed patient charts and records to extract relevant coding information.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Ensured timely filing of all claims within established guidelines.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Verified record copies before handing each over to check for and remove unnecessary details.
- Entered coded data into electronic health record (EHR) systems.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Filed and submitted insurance claims.
- Answered questions and fulfilled requests with friendly and knowledgeable service.
- Collaborated with healthcare providers to verify necessary documentation for coding accuracy.
- Analyzed patient accounts for errors, inaccuracies or discrepancies in billing documentation.
- Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
- Resolved any customer complaints or issues in a timely fashion following established protocols.
- Maintained an organized reception area and ensured that all guests were attended to promptly.
- Responded to customer inquiries via phone, email, and in person.
- Answered incoming calls, redirected callers to the appropriate personnel or department and took messages as needed.
- Updated and maintained office policies and procedures.
- Handled payment processing and provided customers with receipts and proper bills and change.
- Scheduled and confirmed appointments for clients and staff.
- Processed payments from customers using various payment methods including credit cards, checks and money orders.
- Protected clients' rights by maintaining confidentiality of personal and financial information.
- Investigated and analyzed client complaints to identify and resolve issues.
- Photocopied insurance cards, documented details and verified patient coverage for upcoming procedures or appointments.
- Performed data entry accurately into the practice's EMR system as needed.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Checked patients in and out for appointments and collected co-payments.
- Carried out daily tasks by professionally communicating with physicians, nursing staff, technicians and medical assistants.
- Communicated with patients with compassion while keeping medical information private.
- Followed HIPAA guidelines when handling confidential patient information.
- Took messages from patients and promptly relayed them to appropriate staff.
- Scheduled tests, lab work or x-rays for patients based on physician orders.
- Set up appointments for physician visits and procedures using calendar software.
- Retrieved faxes and uploaded documents to patient charts to assist clinical staff.
- Greeted patients warmly, ensuring a positive first impression and efficient check-in process.
- Checked patient insurance, demographic, and health history to keep information current.
- Helped patients complete necessary medical forms and documentation.
Medical Billing and Coding
Neubauer Mental Health Services
09.2023 - 10.2023
- Conducted thorough insurance benefits verifications to ensure accurate billing and patient financial responsibility
- Proficiently used myclientplus.com for post payments, EOB reconciliation, generating reports, and billing, resulting in streamlined billing processes
- Utilized Availity portal to facilitate claims submission and eligibility verification, enhancing administrative efficiency
- Demonstrated expertise in managing write-offs on providers' accounts for patients' insurance billings in compliance with insurance contracts
- Facilitated the timely exchange of patient information by efficiently faxing documents to requesting parties, ensuring the seamless flow of healthcare documentation
Back Up Line Lead
IMI Precision Engineering Seattle
08.2019 - 03.2021
- Set up line daily for my team of up to 10 people
- Conducted morning tier meetings, shared company announcements, and provided leadership for the team throughout the day
- Responsible for accurate inventory on my product line, followed quality control procedures and worked order processing and correctly transacting finished goods for shipment
- Responsible for training new assemblers with operation sheets
- Created efficient scheduling processes or methods to attain production goals
- Entered the needed production orders into planning software
- Assessed current finished products inventory to determine additional needs
- Helped the Line Lead in all supervisory activities and lead in their absence
Assembler I
Norgren Kloehn Inc
02.2019 - 08.2019
- Build parts for medical devices, diagnostic instrumentation, analytical instrumentation, and biotechnology
- Operated assembly machinery to streamline production processes and enhance efficiency.
- Conducted quality inspections to ensure compliance with safety regulations and product specifications.
- Collaborated with team members to optimize workflow and reduce assembly time.
Shift Leader
Taco Bell
11.2013 - 07.2017
- Prepared items according to written or verbal order, working on several different orders simultaneously
- Assisted management with monthly inventory control and weekly stock ordering
- Taking initiative to find extra tasks when scheduled duties were completed
- Followed all established restaurants practices and procedures
- Mastered point of sales (SOP) computer system for automated order taking
- Organized weekly sales reports for the sales department to track product success
Education
Medical Billing & Coding Program -
Northwest Career College
11-2023
Diploma -
Renton Technical College
Renton, WA06-2021
Skills
- ICD-10/CPT/HCPCS Level II Coding
- CMS-1500 Claim Forms
- Claim Entry: Medicare, Medicaid, Private
- Payment & Charge Posting
- Online Claim Submission
- Interpret RA & EOB
- Posting Denials from EOB
- Posting Secondary Insurance
- Practice Fusion
- Collaborate MD
- MOSS
- Creating Referrals & Registrations
- Appointment Scheduling
- Patient Check-In/Out
- Eligibility & Benefits
- Healthcare Reimbursement
- Medical Documentation
- Revenue Cycle Management
- HIPAA Compliance
- Research & Analytical Skills
- Data Entry & Management Skills
- Microsoft Office Suite
- Electronic Health Records
- Medical and Insurance Terminology
- Records Organization & Management
- Tech-Savvy
- Patient Registration
Certification
- Medical Billing & Coding Specialist, National Healthcareer Association, 3.28, Pending
- Adult and child BLS/CPR & AED Certified, American Heart Association, 11/2021
- HIPAA, OSHA, HIV/AIDS (7 hours) Certification, 11/2021
References
Available upon request
Languages
Spanish
Professional Working
English
Professional Working
Timeline
Medical Biller, Medical Front Desk
Epitomedical
02.2024 - Current
Medical Billing and Coding
Neubauer Mental Health Services
09.2023 - 10.2023
Back Up Line Lead
IMI Precision Engineering Seattle
08.2019 - 03.2021
Assembler I
Norgren Kloehn Inc
02.2019 - 08.2019
Shift Leader
Taco Bell
11.2013 - 07.2017
Diploma -
Renton Technical College
Medical Billing & Coding Program -
Northwest Career College