Cynthia Estrada
Los Angeles,CA
Summary
Smart Medical Biller successful at resolving disputes and billing inquiries. Brings organized, professional presentation skills, adherence to strict data confidentiality and HIPAA requirements. Detail-oriented approach, cultivated over more than 6 years, toward performing intricate billing procedures with undeniable level of detail.
Overview
6
6
years of professional experience
Work History
Lead Benefits Specialist
Southern California TMS Center
03.2023 - Current
- Verifying patients eligibility and benefits before services are rendered
- Continuously calling insurance to get better understanding in different insurance policies.
- Generating Invoices for patients responsibility
- Prioritize new patients insurance information
- Led a team of benefits specialist, providing guidance and training to ensure timely completion of tasks.
- Implemented new software solutions that increased productivity within the department while reducing administrative burden on staff members.
- Monitored changes in insurance policies, keeping abreast of updates affecting medical billing procedures and informing staff accordingly.
Medical Billing Specialist
Comprehensive Community Health Centers
12.2021 - Current
- Follow FQHC guidelines
- Use coded data to produce and submit claims to insurance companies
- Verify accuracy of billing data and revise any errors
- Prepare the appropriate claims documents required by each insurer
- Daily closing and balancing of day posted
- Prepare billing and/or rebilling
- Prepare and maintain daily productivity report
- Prepare clean claims to various insurance companies either electronically or by paper
- Answer questions from patients, clerical staff and insurance companies
- Identify and resolve patient billing complaints
- Prepare, review and send patient statements
- Maintain strictest confidentiality; adhering to all HIPAA guidelines/regulations
- Maintain work operations by following policies and procedures; reporting compliance issues
- Collect delinquent accounts by establishing payment arrangements with patients
- Provide customer service regarding collection issues
- Update accounts receivable system with denial and group information
- Review and appeal unpaid claims
- Manage the Accounts Receivable reports
Medical Biller
Los Angeles Center For Ear, Throat And Allergy
03.2021 - 10.2021
- Completed and submitted appeals for denied claims
- Reviewed claims for coding accuracy
- Coordinated communications between patients, billing personnel and insurance carriers
- Handled all electronic and manual payments and adjustments, ensuring that data was accurately posted
- Communicated with medical providers, claimants, lawyers and public officials to provide invested parties with claim information and facilitate necessary participation
- Evaluated open accounts to look for past-due balances and pursue collection strategies.
Medical Billing Specialist
Wound institutes of America
06.2018 - 03.2021
- Performed billing and coding procedures for the emergency room, inpatient, outpatient services, and skilled nursing facility
- Posted and adjusted payments from insurance companies ERA or EOB
- Trained new employees on multiple medical billing programs and data entry software
- Accurately sent out all medical claims through multiple software
- (Office Ally,
- Total MD, Practice Suite, and Trizetto
- Precisely evaluated and verified benefits and eligibility for new and old patients to be able to send clean claims to insurance
- Complied with all HIPAA Privacy and Security Regulations to protect patients' medical records and information
- Researched and followed up on denied insurance claims
- Submitted appropriate appeals to insurances
- Submitted appropriate authorizations to insurance companies
- In charge of all Podiatry billing and Accounts receivable for 4 different hospitals and 16 different nursing facilities
- Managed multiple projects and tasks simultaneously while managing client expectations
- Communicated with multiple Skilled Nursing facilities and Hospitals to Obtain correct patient information
- Worked with patients and their past due bills, created a payment plan or informed them regarding medical bills.
Education
High school diploma -
Apex Technical School
Los Angeles, CADiploma - Medical Billing and Coding
American Career College
Los Angeles, CA2017
Skills
- Microsoft Excel (6 years)
- Microsoft Word (6years)
- Microsoft Outlook (6years)
- Data Entry (6 years)
- 10 Key Data Entry (6 years)
- HIPAA (6years)
- CPT Coding (6 years)
- Medical Billing and Coding (6years)
- Process/Submit claim forms (6 years)
- Filing, Scanning and Faxing (6 years)
- 10 key by touch (6 years)
- Accounts Receivable (6 years)
- Strong Communication skills (6 years)
- Customer service skills, Phone etiquette (6years)
- Bilingual
- Payment Processing and posting(6 years)
- Insurance Knowledge (6 years)
- Claims Adjustments (6 years)
- Knowledgeable in Office Ally, Practice Suite, Trizetto, Total MD and Advanced MD Software Spanish:
- ICD-9
- ICD-10
- CPT software
- Medical Office Experience
- Insurance Verification
- Medical Records
- EMR Systems
- Medical Terminology
- Medical Scheduling
- Documentation review
- Microsoft Access
- Customer service
- EDI
- Medicare
- Communication skills
- Medical billing
- Computer skills
- Google Docs
- Certifications and Licenses
- Medical Coding Certification
- Spreadsheets with Microsoft Excel — Proficient
- Knowledge of various Microsoft Excel features, functions, and formulas
- Full results: Proficient
- Protecting patient privacy — Proficient
- Understanding privacy rules and regulations associated with patient records
- Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued
- Development in any professional field
Additional Information
- Willing to relocate: Anywhere
Timeline
Lead Benefits Specialist
Southern California TMS Center
03.2023 - Current
Medical Billing Specialist
Comprehensive Community Health Centers
12.2021 - Current
Medical Biller
Los Angeles Center For Ear, Throat And Allergy
03.2021 - 10.2021
Medical Billing Specialist
Wound institutes of America
06.2018 - 03.2021
High school diploma -
Apex Technical School
Diploma - Medical Billing and Coding
American Career College
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