Andres Ortega
El Paso,United States
Summary
Efficient Medical Biller with a proven track record in the hospital and healthcare industry. Proficient in medical billing, utilizing systems like Cerner and EPIC Systems. Experienced in Microsoft Office programs for accurate and timely documentation. Committed to delivering high-quality results and exceptional patient care.
Overview
5
5
years of professional experience
Work History
Billing Representative
Optum
11.2023 - Current
- Perform various clerical activities to support daily operations such as, daily clearinghouse rejections, resolving claim edits, and resubmitting accounts using EPIC systems.
- Review encounters for accuracy of CPT and ICD-10 codes, required modifiers, and other data.
- Review aged accounts and take steps to resolve for payment by contacting payors for claim status, process rebilling requests and escalating issues when needed.
- Uses, protects, and discloses patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
- Reviewed and solved account and billing discrepancies.
Billing Specialist 1
Savista RCM
11.2019 - 11.2023
- Generating claims out of EPIC system while ensuring clean claim submission by addressing any edit failures that may exist on the claim.
- Generate late charge claims on accounts.
- Researched and resolved billing discrepancies to enable accurate billing.
- Aid in the revenue cycle process by addressing issues communicated from the AR Specialist such as resubmitting claims or referring accounts to the medical coders for review after they have been denied or rejected by the payor.
- Assist by providing the required medical records or EOB for paper claim submission.
Education
High School Diploma -
Americas High School
El Paso, TX05-2014
Skills
- Microsoft office
- Data entry experience
- ICD-10 knowledge
- HIPAA compliance
- EPIC use
- Critical thinking
Languages
Spanish
Native or Bilingual
Timeline
Billing Representative
Optum
11.2023 - Current
Billing Specialist 1
Savista RCM
11.2019 - 11.2023
High School Diploma -
Americas High School
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