Summary
Work History
Education
Skills
Timeline
Phone
Overview
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Chantell Castaneda

Ontario,CA

Summary

Motivated medical billing and coding specialist,insurance authorization with over 13 years’ experience in health operations management, billing, and coding. Expertise in ICD-9 and, CPT, and HCPCS coding. Highly skilled in analyzing and validating patient information, diagnoses, and billing data. Demonstrated leadership skills that enable the processing of high volumes of patient information to achieve revenue generation goals. Patient registration, Informing patients of their financial responsibility, Knowledge of HMOs, Medicare and Medi-Cal, Private insurance. Determining Co-Pays, deductibles; and obtaining appropriate insurance authorizations.

Professional office support specialist with extensive experience in administrative functions and office management. Known for reliability and adapting to dynamic work environments. Excellent organizational abilities and collaborative mindset ensure seamless team operations and goal achievement.

Work History

Administrative Assistant III

UCLA Health Connie Frank Kidney Transplant Center
04.2022 - Current
  • Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
  • Maintained confidentiality of sensitive information by adhering to strict privacy policies and implementing secure filing systems.
  • Delivered excellent customer service through prompt responses to client inquiries, addressing concerns effectively, and building strong relationships.
  • Ensured accurate record-keeping with diligent data entry and database management for vital company information.
  • Experience with authorization and referral processing.
  • Experience working with in-baskets.
  • Obtain prior authorizations
  • Referral processing
  • Address in-basket messages
  • Appointment scheduling
  • Review of provider schedules
  • Review and upload of medical records
  • Worked effectively in fast-paced environments.
  • Knowledge of specific specialty practice and workflows.
  • Self-motivated, with a strong sense of personal responsibility.
  • Assisted with day-to-day operations, working efficiently and productively with all team members.
  • Skilled at working independently and collaboratively in a team environment.
  • Knowledge of University’s Electronic Health Record System
  • Computer proficiency with Word, Excel, and CareConnect system

Managed Care Collector

Avanti Hospitals/Pipeline Health
02.2020 - 03.2022
  • Follow up with insurance companies to expedite payment on claims
  • Reviewing accounts to determine patient eligibility for various forms of coverage
  • Monitors and/or follow up accounts by using insurance company's web-portal and/or make telephone calls assure timely resolution and accurate reimbursement
  • Appeal unpaid and/or erroneously paid or denied accounts
  • Follow up with insurance companies for claim status, denials, work claims that need to be corrected, coding errors and/or have claims resubmitted for proper reimbursement
  • Worked One Content System to navigate and locate any patient information that may be needed to work accounts, or review of EOB's and ERA's
  • Worked Paragon System, precise documentation in Tickler Notes in Paragon
  • Testing Cerner System for Pipeline Health to ensure proper functionalities of system is working before it goes live
  • Professional telephone etiquette
  • Resolving claims that were being processed without any authorizations
  • Follow up with insurance carriers & submitted authorizations to insure claims were paid accuratly
  • Researched billing errors and discrepancies to initiate corrective action.
  • Consistently met or exceeded individual performance metrics while contributing to team goals as a reliable team player.
  • Contacted customers to discuss payment schedules and set up or immediately process payments.
  • Collaborated with team members to achieve monthly targets, promoting a positive work environment and boosting overall productivity.
  • Reduced outstanding debts by implementing strategic collections tactics and maintaining open lines of communication with customers.

Customer Service Professional

Crossville Studios
06.2010 - 11.2018
  • Provided Billing and Technical support to customers who have questions about their bill, existing services or potential service enhancements
  • Listened to the customers concerns and diffused frustration by providing the customer with options and solutions
  • Worked with customers in past due/soft disco status to negotiate a solution that enables uninterrupted services
  • Developed a strong product and customer service knowledge base on a continuous basis to help drive sales and provide options and vale to the customers
  • Solid work experience, history and references
  • Evaluated customer account information to assess current issues and determine potential solutions
  • Informed customers about billing procedures, processed payments and provided payment option setup assistance
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Developed rapport with customers through active listening and empathetic communication, resulting in enhanced satisfaction levels.

Medical Biller/Collector

MDSynergy LLC
04.2005 - 06.2010
  • Oversee daily Billing Department functions, including medical coding, charge entry, claims, payment posting, and reimbursement management
  • Examine patients encounter forms to verify diagnosis codes, reconcile codes against services rendered
  • Accurately input procedure and diagnosis codes into billing software to generate invoices
  • Used electronic charge capture practices such as billing and account receivables (BAR) system and medical billing
  • Follow up on past due invoices and delinquent accounts to reduce number of unpaid and outstanding balances
  • Document patient data and medical records, perform routine medical record audits to comply with insurance company requirements

Auditor

Smilecare Dental Group
09.2002 - 04.2005
  • Collected, posted, and managed patient account payments, and prepared and submitted claims forms to insurance companies and other third-party payers
  • Performed insurance verification, pre-certification, and pre-authorization
  • Entered procedure and diagnosis codes, and requisite patient information into billing software to streamline invoicing and account management; added modifiers, verified diagnosis, and coded narrative diagnosis
  • Responded to staff and client inquiries regarding CPT and diagnosis codes
  • Prepared special audits and control reports by analyzing trends
  • Facilitated successful internal and external audits through sound and thorough documentation
  • Devised and initiated corrective strategies to improve compliance
  • Provided suggestions to improve management control weaknesses

Claims Assistance/Check Retriever

Farmers Insurance Group
07.2001 - 09.2002
  • Experienced in supporting the claim processing and settlement
  • Knowledge of insurance claims and settlement terms and conditions
  • Strong knowledge of claims systems, claims guidelines, and claims processing methods
  • Excellent analytical, and error-detection skills
  • Remarkable computer, written and verbal communication skills
  • Ability to work with and support the claims staff
  • Effective organizational, planning, and time-management skills

Medical Biller

West Coast Medical Imaging
02.1997 - 07.2001
  • Verification of insurance
  • Billing and coding off doctor’s medical charts
  • Applied HIPAA Privacy and Security Regulations while handling patient information
  • Reviewed received payments for accuracy and applied to intended patient accounts
  • Reviewed all claims for accurateness and appropriateness
  • Answered desk phone and handled phone calls and questions
  • Performed with precision by entering data accurately and researching to resolve questions
  • Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management
  • Collected, posted and managed patient account payments
  • Completed and submitted appeals
  • Submitted claims to insurance companies
  • Reviewed account information to confirm patient and insurance information is accurate and complete
  • Filed and submitted insurance claims
  • Documented and filed patient data and medical records

Education

Some College (No Degree) - Medical Billing, Terminology

East Los Angeles College
Monterey Park, CA

Diploma - General Ed

Garfield High School
Los Angeles, CA
06.1994

Skills

  • Medical Billing ICD-9
  • CPT
  • HCPCS
  • Excellent Interpersonal Skills
  • Excellent Phone Skills
  • Charge Entry on Patient Accounts
  • Claim Entry & Payment Posting
  • Reading of EOB's and ERA's
  • Working Patient Aging Reports
  • HIPAA Compliance
  • Online Claim Submission
  • Patient Registration
  • Informing Patients of their Financial Responsibility
  • Accounts Receivable
  • Medical Office Experience
  • Billing and Collections
  • Customer Service Support
  • Data Entry
  • Documentation
  • Insurance Verification
  • Knowledge of HMOs
  • Medicare
  • Medi-Cal
  • Private insurance
  • Determining Co-Pays
  • Deductibles
  • Obtaining Appropriate Insurance Authorizations
  • Office administration
  • Microsoft Word
  • Microsoft Excel
  • Microsoft outlook
  • Computer proficiency
  • Critical thinking
  • Scheduling
  • Dedicated team player
  • Appointment scheduling
  • Prioritization
  • Workflow optimization

Timeline

Administrative Assistant III

UCLA Health Connie Frank Kidney Transplant Center
04.2022 - Current

Managed Care Collector

Avanti Hospitals/Pipeline Health
02.2020 - 03.2022

Customer Service Professional

Crossville Studios
06.2010 - 11.2018

Medical Biller/Collector

MDSynergy LLC
04.2005 - 06.2010

Auditor

Smilecare Dental Group
09.2002 - 04.2005

Claims Assistance/Check Retriever

Farmers Insurance Group
07.2001 - 09.2002

Medical Biller

West Coast Medical Imaging
02.1997 - 07.2001

Some College (No Degree) - Medical Billing, Terminology

East Los Angeles College

Diploma - General Ed

Garfield High School

Phone

cell, 323-715-4741

Overview

28
28
years of professional experience

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Chantell Castaneda