Anjalia Magdaleno
WEST VALLEY CITY,Utah
Summary
Experienced Medical Billing and Coding Specialist with advanced knowledge of insurance processes and codes. Organized, reliable, driven and adaptable with excellent planning and problem-solving abilities. Over 10 years of insurance claims appeals and understanding of coding and surgical terminology.
Overview
13
13
years of professional experience
Work History
Medical Appeals and Coding Specialist, Sr.
University Medical Billing
02.2017 - Current
- Monitored coding denials and appeals for quality of the revenue cycle.
- Conducted high-level review of reports, escalated denial issues, and developed recommendations for a course of action based on the analysis of data to aid in reduction of denials.
- Managed high volumes of medical records efficiently while maintaining strict attention to detail during the coding process.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Ensured accuracy in coding through regular audits, identifying discrepancies and areas for improvement.
- Maintained strict confidentiality in accordance with HIPAA regulations, ensuring secure storage and handling of sensitive patient information.
- Enhanced revenue and reduced error rates in medical billing by maintaining thorough knowledge of insurance guidelines, implementing edits and providing education to billing staff.
- Trained new staff members on medical billing processes and best practices, fostering a knowledgeable workforce capable of providing excellent service to clients.
Medical Billing Account Specialist
University Medical Billing
07.2012 - 02.2017
- Resolved complex billing and payment issues to maintain billing accuracy.
- Managed multiple accounts simultaneously, demonstrating exceptional organizational skills and attention to detail.
- Contacted insurance companies for patient medical billing operations.
- Reviewed and eacalated accounts with payer representatives
Account Resolution Specialist
University Medical Billing
06.2011 - 06.2012
- Submitted medical record documentation to insurance payers for denial review
- Called insurance companies to follow-up with account information
- Resolved various medical billing edits
Education
CPC - Medical Billing And Coding
Fortis College
Salt Lake City, UT11.2010
Skills
- ICD-10 Coding
- Certified Professional Coder (CPC)
- Billing and Collections
- Reimbursement followup
- HIPAA Compliance
- Insurance claims analysis
- Coding Error Resolution
- Extensive Claims Appeal Knowledge
- Denial trending and follow-up
- Insurance Policies Understanding
- Microsoft PowerPoint, Excel, Word and Outlook
- Expert in State and Federal Regulations
Timeline
Medical Appeals and Coding Specialist, Sr.
University Medical Billing
02.2017 - Current
Medical Billing Account Specialist
University Medical Billing
07.2012 - 02.2017
Account Resolution Specialist
University Medical Billing
06.2011 - 06.2012
CPC - Medical Billing And Coding
Fortis College
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