CRYSTAL M. RODRIGUEZ
Bakersfield,CA
Summary
Highly organized and efficient administrative professional. Seeking a challenging, responsible full time position that will utilize my skills and abilities.
Overview
18
18
years of professional experience
Work History
Insurance Representative II
Pfsgroup
08.2023 - Current
- Maintained knowledge of standardized medical billing codes.
- Submitted patient statements and medical billing to insurance companies.
- Contacted insurance companies for patient medical billing operations.
- Updated patients' medical records using electronic recordkeeping system.
- Worked with outside entities to resolve issues with billing, claims, and payments.
- Maintained confidentiality of patient demographic, medical and financial information.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Posted and adjusted payments from insurance companies.
- Identified and resolved patient billing and payment issues.
- Located errors and promptly refiled rejected claims.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Verified insurance of patients to determine eligibility.
- Liaised between patients, insurance companies, and billing office.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
Medical Biller
Good Samaritan Hospital Medical Center
11.2020 - 08.2023
- Inpatient/ Outpatient Facility billing, Behavioral Health billing, RHC billing.
- Submitting claims to insurance companies electronically
- Assigned ICD-10 codes to physicians diagnosis and insured the correct level of service and various CPT codes
- Maintain strick patient confidentiality
- Identifying and billing secondary and tertiary insurances
- Researching and appealing denied claims
- Knowledge in all commerical, private and managed care programs including Medicare and Medicaid
- Make necessary contact with insurance payers or patients to ensure maximum reimbursements
- Review referrals and authorizations
- Entered CPT codes and patient information into billing software
- AR followups on aging reports
Account Representative /Medical Billing Specialist
Protégé Medical Billing Services LLC
02.2014 - 11.2020
- Surgery medical coding and electronic billing
- Bariatric Billing Specialist
- Accurately assigned ICD 10 and CPT codes to patient’s medical records
- Reviewed physician’s operative reports
- Communicated with insurance companies regarding denials, claim status, appeals and disputes
- Electronic posting of insurance payments
- Appealed and dispute denied claims, corrected claim billing
- Aging outstanding accounts
- Patient statements
- Reviewed invoices according to contracts with insurance companies
- Knowledge of medical terminology, ICD 10 and CPT codes
- Excellent data entry skills
- Month end reports
- Microsoft 365, Collaborate MD, Practice Fusion, Office Ally, Super Coder, Encoder, Hospital and Insurance portals
- Karen Zupko surgery coding training workshops.
Front Office Manager /Dental Assistant
Marina View Dentistry
10.2010 - 09.2014
- Maintained accounts receivables
- End of year reports
- Daily cash deposits
- Scheduling appointments
- Treatment planning with patients regarding insurance deductibles and coinsurance
- ADA-coding
- Electronic dental billing to all PPO insurances, NEA attachments, Trojan and Claim Connect
- Electronic posting of insurance payments, corrected billing
- Data entry
- Assisting dental physician with general, oral and implant surgery
- Sterilization of instruments
- Certified California X-ray license
- Checking out patients after treatment.
Front Office Receptionist / Dental Assistant
Johnson Family Dental
03.2007 - 10.2010
- Check patients into appointments
- Scheduling various appointments
- Collect patient copays
- Verified insurance eligibility
- Obtained authorizations for PPO patient services
- Maintained accurate accounts payable/receivable end of the month reports
- Daily cash deposits
- Prepare patient charts
- Assist dental physicians with general and oral surgery
- Billing ADA-coding.
- Provided clerical support to company employees by copying, faxing, and filing documents.
Education
High School Diploma -
VENTURA HIGH SCHOOL
Ventura, CA06.2001
Skills
- Medical Terminology
- Verbal and Written Communication
- Multitasking and Organization
- Commercial and Private Insurance
- ICD-10 Coding
- Clerical Support
- Teamwork and Collaboration
- Billing and Invoicing
- Insurance Verification
- HIPAA Compliance
- Claim submission
- Collections Management
- Claims review
Timeline
Insurance Representative II
Pfsgroup
08.2023 - Current
Medical Biller
Good Samaritan Hospital Medical Center
11.2020 - 08.2023
Account Representative /Medical Billing Specialist
Protégé Medical Billing Services LLC
02.2014 - 11.2020
Front Office Manager /Dental Assistant
Marina View Dentistry
10.2010 - 09.2014
Front Office Receptionist / Dental Assistant
Johnson Family Dental
03.2007 - 10.2010
High School Diploma -
VENTURA HIGH SCHOOL
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