Dana Jaramillo
Kirtland,NM
Summary
Medical Billing Supervisor with over 15 years of expertise in team leadership, claims processing, and HIPAA compliance.
Experienced with managing medical billing processes and leading billing teams to ensure operational efficiency. Utilizes advanced knowledge of healthcare billing systems to identify and resolve discrepancies. Track record of implementing process improvements and maintaining compliance with industry regulations.
Overview
40
40
years of professional experience
Work History
Medical Billing Supervisor
San Juan Regional Medical Center
Farmington, NM
12.1989 - Current
- Supervised billing operations, ensuring compliance with regulatory standards and internal policies.
- Streamlined billing processes, enhancing accuracy and reducing processing time for claims submissions.
- Mentored staff on best practices in medical billing procedures to improve team performance.
- Implemented training programs to enhance knowledge of insurance protocols among billing personnel.
- Analyzed billing data to identify trends.
- Collaborated with healthcare providers to resolve discrepancies in patient accounts and maximize reimbursement rates.
- Developed and maintained relationships with insurance companies to facilitate efficient claim processing.
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Interceded between employees during arguments and diffused tense situations.
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
- Delegated tasks to administrative support staff to organize and improve office efficiency.
- Supported staff during high volume peaks.
Sales Associate
Hacienda Home Centers
Farmington, NM
05.1986 - 12.1989
- Processed transactions efficiently using point-of-sale systems, ensuring accuracy in cash handling.
- Collaborated with team members to achieve store sales goals and improve overall performance.
- Greeted customers and helped with product questions, selections, and purchases.
- Helped customers complete purchases, locate items, and join reward programs.
- Handled returns and exchanges professionally, resolving customer issues while adhering to company policies.
- Assisted in managing inventory levels, accurately processing shipments, and restocking merchandise as needed.
- Coordinated with stock team to expedite restocking of high-demand items.
- Managed cash register, ensuring accurate transactions and safeguarding against losses.
- Participated in periodic inventory counts to maintain accurate stock levels.
Education
No Degree - Accounting And Finance
San Juan College
Farmington, NMHigh School Diploma -
Kirtland Central High School
Kirtland05-1985
Skills
- Team leadership and supervision (15years)
- HIPAA compliance
- Claims processing proficiency
- Electronic health records
- Effective communication
- Staff training and development
- ICD-10 knowledge
- CPT/HCPCS/Modifiers
- DRG
- CMG
- Medicare and Medicaid regulations
- Commercial insurance policies
- Electronic claims 837I & 837P
- CMS-1500 billing
- CMS-1450 (UB04) billing
- Insurance collections/Appeals
- CERNER
- MEDITECH
- SSI
- FINTHRIVE
- Quadax
- Claim MD
- Vitalware
- Availity
- Inovalon
- Medical billing technology
- Microsoft 365 (Excel, Word, Outlook, Powerpoint, One Drive)
- 10 Key
- Implementation and testing of new EHR's
- Administrator for payer sites
- Provider enrollment with payers
Accomplishments
- Developed tracking spreadsheets and KPI.
- Completed Frontline Leadership 8 month training program.
- Collaborated with team to implement billing systems.
- Maintained clean claim rate of 90% and above prior to being scrubbed.
Timeline
Medical Billing Supervisor
San Juan Regional Medical Center
12.1989 - Current
Sales Associate
Hacienda Home Centers
05.1986 - 12.1989
No Degree - Accounting And Finance
San Juan College
High School Diploma -
Kirtland Central High School