ALICIA ORTEGA
Brighton,CO
Summary
Self detailed oriented individual, customer service, spanish speaking. Office experience.
Detail-oriented Medical Billing Specialist with bilingual proficiency in Spanish, proficient in processing medical claims and ensuring accuracy in patient accounts. Committed to maintaining compliance with HIPAA regulations and enhancing customer service through effective communication with patients and insurance providers.
Overview
1
1
year of post-secondary education
4
4
years of professional experience
Work History
Medical Billing Specialist
Sunrise Community Health
Evans, CO
01.2018 - 08.2021
- Processed medical claims using electronic billing systems.
- Reviewed patient accounts for accuracy and completeness.
- Communicated with insurance companies to resolve claim discrepancies.
- Assisted patients with billing inquiries and payment options.
- Maintained up-to-date knowledge of insurance policies and regulations.
- Collaborated with healthcare providers to obtain necessary documentation.
- Implemented best practices for efficient claim submissions.
- Trained new staff on billing procedures and software usage.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Adhered to HIPAA regulations when handling confidential patient information.
- Posted charges and processed payments in billing system.
- Completed appeals and filed and submitted claims.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Applied payments, adjustments, and denials into medical manager system.
- Maintained detailed records of all billing activities including denials, adjustments, and payments received.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
- Submitted appeals for denied claims when appropriate according to the insurance company's criteria.
- Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
- Provided customer service support to patients who had questions about their bills or payments due.
- Submitted refund requests for claims paid in error.
Education
Associate of Arts - Medical Billing
Westwood Community College
Denver, ColoradoAssociate of Arts - Accounting
Detroit Lakes Vocational School
Detroit Lakes, Minnesota 08.1978 - 08.1979
Skills
- Medical coding
- Billing Procedures
- Claims processing
- Electronic billing
- Medical Terminology
- Customer service
Timeline
Medical Billing Specialist
Sunrise Community Health
01.2018 - 08.2021
Associate of Arts - Accounting
Detroit Lakes Vocational School
08.1978 - 08.1979
Associate of Arts - Medical Billing
Westwood Community College