Claudia Montano
Houston,TX
Summary
Dedicated Medical Billing and Coding Specialist committed to implementing comprehensively organized billing and documentation policies. Adept at the analysis and interpretation of medical documentation, coordinating with medical providers to ensure care, and preparing and submitting claims to insurance companies. Specialize in auditing medical accounts and verifying medical documents. With 11 years of knowledge of EClinicalWorks
Overview
8
8
years of professional experience
Work History
Patient A/R Representative
Addison Group
03.2025 - Current
- Communicating with patients and their families about the details of their bills and insurance restrictions
- Maintaining exceptional professional customer service during patient interactions
- Obtaining copay amounts and explaining medical terminology to patients at the end of their treatments
- Advising patients on nearby care based on referrals from the physician
Patient A/R Representative
Oncology Consultants
06.2023 - 09.2024
- Analyzed customer accounts, identifying payment discrepancies.
- Researched and resolved customer payment discrepancies.
- Provided customer service to patients regarding billing inquiries and account information.
- Assisted in resolving patient complaints related to account balances, insurance coverage, and payment plans.
- Processed payments from patients and maintained accurate records of all transactions.
- Issued refunds for customers as needed.
- Worked closely with delinquent account holders to collect and reconcile accounts through approved channels.
BILLING SPECIALIST
Houston Pulmonary Medicine
03.2021 - 06.2023
- Verify insurance eligibility and benefits for treatments, services, and procedures.
- Communicate and educate patients and families of their insurance benefits and coverage.
- Assure all insurance requirements have been accurately obtained for each patient before proceeding to scheduling.
- Timely submittal of insurance claims through EMR system.
- Timely research and submit appeals and reconsiderations on claim denials and underpayments.
- Timely posting of ERAs.
- Reconciliation of client accounts.
- Communicate identified payer trends such as denials for specific procedure or diagnosis codes, or other issues to direct manager.
- Collection of client payment charges.
- Post payments in patient accounts.
- Problem solving by identifying and resolving patient payment discrepancies with front office staff.
Medical Biller
Hillcroft Physicians
06.2017 - 07.2020
- Applied HIPAA privacy and security regulations while handling patient information.
- Completed and submitted appeals for denied claims.
- Reviewed claims for coding accuracy.
- Input details into accounts and tracked payments.
- Coordinated communications between patients, billing personnel and insurance carrier.
- Run and analyze balancing reports to ensure accurate posting.
- Provider credentialing as necessary.
- Cross-train on other billing duties for back-up when needed.
- Other duties as assigned by the direct manager.
Education
Certified Medical Office Specialist - Insurance Office Reconciling
Career Centers of Texas
Brownsville, TXG.E.D - undefined
Continuing Education
Brownsville, TXSkills
- Financial Benefits
- Cash flow
- Decision making Diagnosis
- Insurance
- Office Reconciling Reporting
Timeline
Patient A/R Representative
Addison Group
03.2025 - Current
Patient A/R Representative
Oncology Consultants
06.2023 - 09.2024
BILLING SPECIALIST
Houston Pulmonary Medicine
03.2021 - 06.2023
Medical Biller
Hillcroft Physicians
06.2017 - 07.2020
Certified Medical Office Specialist - Insurance Office Reconciling
Career Centers of Texas
G.E.D - undefined
Continuing Education
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