BIANCA LEYVA
WATSONVILLE,CA
Summary
At Monterey Peninsula Surgery Center, I leveraged my expertise in medical billing and coding, along with exceptional customer service skills, to enhance billing efficiency and patient satisfaction. My proactive approach in claim submission and denial management, backed by a solid foundation in HIPAA compliance and ICD-10 proficiency, significantly improved the revenue cycle. My collaborative efforts fostered strong team dynamics, contributing to a streamlined billing process.
Overview
16
16
years of professional experience
Work History
Medical Billing Specialist
Monterey Peninsula Surgery Center
Monterey, CA
02.2009 - Current
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Located errors and promptly refiled rejected claims.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Identified and resolved patient billing and payment issues.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
- Handled account payments and provided information regarding outstanding balances.
- Generated monthly billing and posting reports for management review.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Maintained accurate records of customer payments.
- Audited and corrected billing and posting documents for accuracy.
- Used data entry skills to accurately document and input statements.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Utilized various software programs to process customer payments.
- Collaborated with customers to resolve disputes.
- Responded to customer concerns and questions on daily basis.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Adhered to established standards to safeguard patients' health information.
- Delivered timely and accurate charge submissions.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Posted payments and collections on regular basis.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Verified insurance of patients to determine eligibility.
- Developed customized reports for management review, highlighting trends in key performance metrics such as claim denial rates and days outstanding for accounts receivable balances.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Evaluated patients' financial status and established appropriate payment plans.
- Collaborated closely with the clinical team to ensure proper documentation was obtained for accurate billing purposes.
- Continuously updated knowledge of industry regulations and compliance requirements, ensuring adherence to all applicable standards.
- Increased overall efficiency of the billing department by regularly auditing internal procedures and suggesting improvements.
- Educated colleagues on best practices in medical billing, providing ongoing training sessions as needed.
- Contributed to overall office organization by maintaining up-to-date records of all billed services and payments received.
- Reduced errors in medical billing by meticulously reviewing patient records and ensuring accurate coding.
- Prepared billing correspondence and maintained database to organize billing information.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Conducted regular audits of patient accounts for potential underpayments or overpayments due to incorrect coding or billing practices.
- Monitored changes in payer requirements, adjusting billing practices accordingly to minimize disruptions in the revenue cycle.
- Participated in departmental meetings, sharing insights and ideas for improving overall medical billing efficiency and revenue generation.
- Efficiently processed refunds or adjustments for patients when necessary, ensuring accuracy and compliance with company policies.
- Streamlined billing processes by implementing efficient workflows and utilizing advanced software tools.
- Served as a subject matter expert on medical billing matters, providing guidance to colleagues on complex cases or unique situations.
- Liaised between patients, insurance companies, and billing office.
- Coordinated with other departments to address any discrepancies or concerns related to charge capture or data entry accuracy.
- Filed and updated patient information and medical records.
- Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
- Precisely evaluated and verified benefits and eligibility.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Collected payments and applied to patient accounts.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
Nurse Assistant
Monterey Peninsula Surgery Center
Monterey, CA
02.2009 - Current
- Checked patient vitals such as temperature, blood pressure, and blood sugar levels.
- Promoted good oral and personal hygiene by aiding patients with shaving, bathing, and teeth brushing.
- Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.
- Supported patient mobility by transferring them from bed to chair or other locations using proper lifting techniques, reducing the risk of injury for both patients and staff members alike during such activities.
- Demonstrated strong teamwork skills when working alongside fellow nurse assistants, nurses, physicians and other healthcare professionals striving towards common goals centered around providing high-quality care tailored specifically towards meeting individual patient needs as they arise throughout course treatment process.
- Maintained accurate documentation of patient records, contributing to efficient communication among healthcare team members.
- Improved patient care by assisting nurses with daily tasks and providing compassionate support to patients.
Front Office Receptionist
Monterey Peninsula Surgery Center
Monterey, CA
02.2009 - Current
- Reduced wait times for callers, promptly answering phone lines and directing calls as needed.
- Maintained clean reception area to promote positive, professional environment for clients.
- Maintained a high level of professionalism while handling sensitive customer information, ensuring privacy and confidentiality.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Ensured a welcoming atmosphere for guests with efficient check-in and check-out procedures.
- Collaborated with team members for smooth workflow, supporting colleagues during peak hours or absences.
- Contributed to the company''s positive image by consistently delivering exceptional service to clients and visitors.
- Directed incoming calls to internal personnel and departments, routing to best-qualified department.
- Answered multi-line phone system and enthusiastically greeted callers.
- Identified visitors' needs to offer solutions and information.
- Provided clerical support to company employees by copying, faxing, and filing documents.
- Assisted management with administrative tasks such as data entry, filing, and report generation as required.
- Greeted visitors and customers upon arrival, offered assistance, and answered questions to build rapport and retention.
- Offered every visitor professional and prompt service, completing check-ins, verifying paperwork and coordinating smooth hand-offs to nursing staff.
- Organized incoming mail distribution system that streamlined delivery of important documents among employees.
- Increased efficiency through proficient use of office software, including word processing and spreadsheet applications.
- Streamlined front office operations by effectively managing appointments and maintaining up-to-date patient records.
- Minimized errors in medical paperwork by checking terminology and complying with insurance policies.
- Developed strong relationships with clientele through excellent communication skills and genuine attentiveness to their needs.
- Completed all tasks in compliance with company policies and procedures.
- Maintained confidentiality of sensitive data to protect customer and business information.
Education
CERTIFICATE OF MEDICAL ASSISTING - HEALTHCARE
CENTRAL COAST COLLEGE
Salinas, CA12.2008
High School Diploma -
WATSONVILLE HIGH SCHOOL
Watsonville, CA06.2007
Skills
HIPAA Compliance
Payment posting
Claim submission
Insurance Verification
Patient Billing
CPT Knowledge
Denial Management
ICD-10 Proficiency
Medicare and Medicaid process
Medical Coding Expertise
Insurance Billing
Data Entry
Medical Billing
Medicaid and Medicare Knowledge
ICD-10
Insurance Claims
Medical Terminology
Claims review
Billing and Collection Procedures
Insurance claims processing
Critical Thinking
ICD-10 Coding
Customer Service
Electronic Claims
Teamwork and Collaboration
CMS-1500 Billing Forms
Medical coding knowledge
Medical claims submission
Commercial and Private Insurance
HIPAA Compliance Certification
Medical terminology expert
Claims Processing
Worker's Compensation Knowledge
Medical record security
Languages
Spanish
Native or Bilingual
Timeline
Medical Billing Specialist
Monterey Peninsula Surgery Center
02.2009 - Current
Nurse Assistant
Monterey Peninsula Surgery Center
02.2009 - Current
Front Office Receptionist
Monterey Peninsula Surgery Center
02.2009 - Current
CERTIFICATE OF MEDICAL ASSISTING - HEALTHCARE
CENTRAL COAST COLLEGE
High School Diploma -
WATSONVILLE HIGH SCHOOL