Claudia Flores
Odessa,TX
Summary
Hardworking, quick learning, bilingual professional with excellent analytical and multitasking abilities. Considered focused, dependable and organized team player with passion for resolving discrepancies through attention to detail and creative problem-solving.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Medical Biller
Dr. Vivek Rao
07.2011 - Current
- Entered patient demographic and billing information in billing system to maintain accurate records.
- Posted and printed daily tills.
- Printed out and kept track of Explanation of Benefits from insurance companies.
- Translated in Spanish for patients.
- Kept up with adding daily credit card and daily insurance payments for tax purposes.
- Contacted patients regarding old balances and successfully collected.
- Mailed monthly statements.
- Printed out yearly statements for patient tax purposes.
- Set up and kept track of payment plans and posted payments into EHR system.
- Posted invoices.
- Directed other employees on what to work on.
- Called prescriptions in to pharmacies.
- Verified patient eligibility and coverage prior to appointments.
- Assisted patients with understanding their insurance coverage and financial responsibilities.
- Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Maintained positive cash flow within the organization by ensuring timely submission of clean claims and diligent follow-ups on outstanding payments.
- Collected payments and applied to patient accounts.
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Maintained strict confidentiality of patient information, adhering to HIPAA regulations and medical office policies.
- Privacy officer, dealt with any HIPAA issues patients had.
- Optimized workflow efficiency by cross-training in tasks such as scheduling appointments or managing phone calls during peak periods.
- Tracked and uploaded medical records into electronic medical records system.
Education
Associate of Arts -
Odessa College
Odessa, TX05.2019
High School Diploma -
Odessa High School
Odessa, TX05.2011
Skills
- Insurance Claims
- Medical Billing
- HIPAA Compliance
- Insurance Verification
- Billing and Collection Procedures
- CPT Knowledge
- Accounts Receivable
- Denial Management
Certification
- NCICS - Insurance and Coding Specialist
Timeline
Medical Biller
Dr. Vivek Rao
07.2011 - Current
Associate of Arts -
Odessa College
High School Diploma -
Odessa High School
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