Amanda Ochoa
Casa Grande,AZ
Summary
Efficient Revenue Cycle Management Specialist /Accounts Receivable Representative offering 11 years of experience. Excellent knowledge of collection and claims procedures with strong communication skills. Researched denied claims and submitted appeals. Proficient in tracking payments, resolving billing issues and preparing account statements. Recognized as dedicated professional driven to meet team targets and enhance bottom-line performance. Can work 60-80 accounts a day.
Overview
16
16
years of professional experience
1
1
Certification
Work History
RCM Specialist
Keplr Vision
07.2023 - Current
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Located errors and promptly refiled rejected claims.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Coordinated with other departments to address any discrepancies or concerns related to charge capture or data entry accuracy.
- Participated in departmental meetings, sharing insights and ideas for improving overall billing efficiency
- Used critical thinking to break down problems, evaluate solutions, and make decisions.
- Adaptable and proficient in learning new concepts quickly and efficiently.
- Identified and resolved patient billing and payment issues.
RCM SPECIALIST/AR REPRESENTATIVE
Nationwide Vision
Mesa, AZ
08.2016 - 04.2023
- Communicated with insurance providers to resolve denied claims and resubmitted
- Worked with using different software such as Trizetto, Ilogic, Excel and MaximEyes, Waystar and Instamed.
- Data Entry
- Worked effectively with multiple commercial insurances to obtain timely and accurate payments (Davis Vision, Superior Vision, VSP, Always Vision and Spectera)
- Identified, researched and resolved billing variances to maintain system accuracy and currency
- Trained new employees on multiple medical billing programs and data entry software
- Identified and resolved patient billing and payment issues
- Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable
- Reviewed patient records, identified medical codes and created invoices for billing purposes
- Prepared accounts with past due balances and billed the patient.
- Utilized electronic billing systems to submit claims to insurance providers in a timely manner.
- Performed data entry tasks such as entering patient information into practice management software.
- Monitored payer contracts for changes in reimbursement policies or new fee schedules.
- Identified potential opportunities for improvement in current processes related to medical billing activities.
- Developed strong working relationships with insurance companies in order to facilitate prompt payments of claims.
AR REPRESENTATIVE
Silvertree Health
Chandler, AZ
07.2010 - 12.2011
- Thoroughly investigated past due invoices and minimized number of unpaid accounts
- Completed appeals and filed and submitted claims
- Posted payments and adjustments
- Submitted refund requests for claims paid in error
- Meticulously tracked and resolved underpayments
Education
Lamson college
07.2010
DIPLOMA - undefined
casa grande union high
05.2006
Skills
- Attention to detail
- Multitasking
- Critical Thinking
- Obtaining Authorizations
- CMS-1500 Billing Forms
- HIPAA Compliance
- Problem-Solving Strengths
- 10-Key Data Entry
- Insurance claims processing
- Medical claims submission
- Multitasking and organization
Certification
Medical Billing and Coding Specialist
Timeline
RCM Specialist
Keplr Vision
07.2023 - Current
RCM SPECIALIST/AR REPRESENTATIVE
Nationwide Vision
08.2016 - 04.2023
AR REPRESENTATIVE
Silvertree Health
07.2010 - 12.2011
DIPLOMA - undefined
casa grande union high
Lamson college