Alma Vidal
Warrensburg,MO
Summary
Motivated Patient Account Representative offering six years of healthcare and customer service experience. Highly effective time management, conflict resolution and communication skills.
Overview
7
7
years of professional experience
Work History
Medical Billing Assistant
Katy Trail Community Health
Sedalia, MO
09.2023 - Current
- Performed follow-up on unpaid or rejected claims with insurance providers.
- Verified insurance coverage and eligibility for medical services rendered.
- Entered data into electronic billing system.
- Assisted patients in understanding the details of their billings and payments.
- Investigated denials from insurance carriers and resubmitted claims as needed.
- Maintained accurate records of claims processing in compliance with HIPAA regulations.
- Submitted appeals to insurance companies when necessary.
- Reconciled account balances when necessary due to incorrect payments or rejections from payers.
- Reviewed Explanation of Benefits statements from insurers for accuracy against charges submitted to ensure proper reimbursement was received.
Patient Account Representative II
Cook Children's Home Health
Fort Worth, TX
11.2017 - 08.2023
- Electronically submitted claims according to compliance guidelines.
- Worked with outside entities to resolve issues with billing, claims and payments.
- Responded to patient, family and external payer inquiries.
- Accurately responded to high inbound call volume.
- Posted payments and processed refunds to both patients and payors.
- Entered client details and notes into system for interdepartmental access and review.
- Prevented impending loss and increased profitability by enforcing medicaid rates, consistently achieving targeted contracted rates.
Patient Service Coordinator
Cook Children's Home Health
Fort Worth, TX
11.2016 - 11.2017
- Contacted insurance company to verify patient coverage before medical equipment was provided.
- Demonstrated exceptional customer service to provide welcoming and professional environment for patients.
- Verified patient's insurance eligibility and benefits coverage through medicaid and commercial insurances portals.
- Communicated with primary care offices and insurance companies to obtain authorization/required forms.
- Collected deductable/oop payments and issued receipts.
Education
Associate of Arts -
Tarrant County College
Fort Worth, TX2021
Skills
- Patient Account Reviews
- Verbal and Written Communication
- Reviewing Patient Information
- Payment Processing
- Medical Billing
- Account Resolutions
- Organizational Skills
- HIPAA Understanding
- Insurance Billing
- AR Aging Reports
- Account Reconciliation
Accomplishments
- Maintained an AR of over 2,000 claims under 2%.
- Documented and resolved forwarding balances which led to correct offsetting of accounts.
- Built productive relationships with insurance companies, increasing payment rates.
Languages
Spanish
Native/ Bilingual
Qualifications
- Medical/Physician billing
- CPT and HCPC
- Appeals, Reconsiderations, EOBs
- Medical, Commercial and Medicare plan experience
- Microsoft excel, HDMS, Nitro, eCW, Teams, Waystar, Availity
Timeline
Medical Billing Assistant
Katy Trail Community Health
09.2023 - Current
Patient Account Representative II
Cook Children's Home Health
11.2017 - 08.2023
Patient Service Coordinator
Cook Children's Home Health
11.2016 - 11.2017
Associate of Arts -
Tarrant County College
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