Caren Caldeyro
National Billing
Margate,FL
1
Certification
17
years of professional experience
To obtain a challenging position in the medical field where medical skills and training can be utilized to provide healthcare services to all patients.
Experienced with leading teams to achieve project goals through effective management and strategic planning. Utilizes strong organizational and communication skills to foster collaboration and drive performance. Track record of successfully overseeing project execution and adapting to dynamic work environments.
Work History
Team Lead Medical Biller
6 Years 10 Months- Experienced full-time Team Lead medical biller overseeing training on new hires. Handles all the billing functions for doctors' offices and other types of medical providers nationwide.
- Have used Kareo Practice Management billing software or similar billing systems and Require little software training, enjoy collecting on unpaid claims, researching claims, finding why claims didn't pay and know all the claim research websites as well as knowing how to post money, work denials and appeal claims. Knowledge of all insurance claim websites to work outstanding claims, look up claim status and working accounts receivable is also required.
- I have worked with different medical billing companies and have proven working knowledge of medical billing and collections and be able to start immediately working accounts. Have excellent understanding of Ins. company claim websites, obtaining EOB's, working A/R, posting, working denials and appealing claims and years experience working accounts receivables for a medical practice, large busy doctors' office or worked for a billing company doing medical billing and working claims A/R and getting claims paid. Team player with great customer service skills, ability to multitask and knows how to get medical claims paid!
Medical Assistant/Medical Biller
4 Years 8 Months- Managed phone communications, performed clerical tasks including copying, faxing, and filing, ordered supplies, called in medications or e-scripts, and scheduled patient appointments to ensure efficient office operations.
- Administer TB and FLU vaccines, Drug screening for new hires
- Updated physician credentialing with insurance companies and submitted medical billing claims using ICD10/CPT and HCPCS codes, ensuring compliance and accuracy in billing processes.
- Secured referrals and pre-authorizations for medical procedures.
- Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.
- Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
- Prepared, reviewed, and transmitted claims using billing software, facilitating both electronic and paper claim processing for timely reimbursement.
- Following up on unpaid claims within standard billing cycle timeframe.
- Calling insurance companies regarding any discrepancy in payments if necessary identifying and billing secondary or tertiary insurances.
- Researching and appealing denied claims.
Physician Biller
2 Years 1 Month- Managed labor and delivery work queue of over 300 claims, utilizing high-volume collections experience with HMOs, PPOs, Medicare, and Medicaid.
- Knowledge of EOBs, CPT & ICD-10 codes, HCFAs, UB04s, HCPCS
- Demonstrated ability to excel in production-driven environments, consistently meeting performance targets.
- Executed collections calls and assisted new mothers with Medicaid applications while effectively managing time and multitasking.
- Proficiency with, Epic, MD Office , Connect Care Microsoft Outlook suite of products; demonstrated aptitude for learning new software programs
- Superior verbal and written communication skills
Account Lead Manager
5 Years- Greeted patients, ensuring accurate updates of demographics and insurance information.
- Gather information pertaining to patient insurance coverage and enter into patient/hospital data base.
- Ensure adequate staffing is set up at all four locations, to include weekly schedules, collecting payroll and reviewing leave requests.
Education
Associate - Private Investigation
Certification - Medical Assistant
Skills
Medical Billing (15 years)
Medical Insurance (15 years)
Medical Coding (15 years)
CPT Coding
Medical office administration
ICD-9
CPT codes
Medical Collection
Insurance Verification
EMR Systems
Epic
Medical Office Experience
Medical Records
Patient Care
Anatomy Knowledge
Certification
- Medical Billing — Highly Proficient
- November 2019
- Understanding the procedures and forms used for medical billing.
- Full results: Highly Proficient
- Electronic Medical Records: Best Practices — Completed
- December 2019
- Knowledge of EHR data, associated privacy regulations, and best practices for EHR use
- Full results: Completed
- Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
Additional Information
- AREAS OF EXPERTISE:
- Maintain composure and professionalism while performing duties in a fast-paced environment.
- Utilize tact and good communication skills when interacting with staff, patients, and family members.
- Use correct spelling, medical terminology and abbreviations when documenting pertinent and confidential medical terminology.
- Recognizes and responds calmly and appropriately in emergency situations.
Personal Information
- Title: Lead Medical Biller
- Work Permit: Authorized to work in the US for any employer
Timeline
Team Lead Medical Biller
National Billing
12.2019 - CurrentRead More
Physician Biller
Children's Specialty Group
12.2016 - 01.2019Read More
Medical Assistant/Medical Biller
Dr. James Hatcher Office
03.2015 - 11.2019Read More
Account Lead Manager
Portsmouth Naval Medical Center
11.2009 - 11.2014Read More
Concord Career College
Certification from Medical Assistant
Read More
City College
Associate from Private Investigation
Read More