DEBORAH LEMUS
Ontario,CA
Summary
Detail-oriented administrative assistant and medical biller with four years of experience in SIBTF and PTP claims processing. Expertise in verifying Medical and Medicare insurance with three years of dedicated experience. Achieved an end-of-month billing amount of $2 million across two divisions, demonstrating strong financial management skills.
Overview
9
9
years of professional experience
Work History
Administrative Assistant/ Medical Biller
Disabled Workers Advocates
Chino Hills, CA
06.2022 - Current
- Administered comprehensive intake of health questionnaires via phone, gathering critical medical history information to support patient care.
- Facilitated communication between English and Spanish speakers, both over the phone and in person.
- Directed incoming calls to the appropriate department to facilitate timely responses. and directed callers to appropriate department or employee.
- Enter patient data information such as demographics, in BASE database system.
- Review and ensure all records have been received to be prepared for Medical Billing.
- Entered patient demographic information, doctor details, diagnosis codes, and billing codes into Daisy bill system to bill Dr. reports.
- Managed the timely completion of medical billing for QME, PTP, and SIBTF cases.
- Determine Dr. and Administrative percentages based on the bill amount.
- Assist patients in completing necessary forms prior to their doctor appointments
- Assist and travel with Doctors to their evaluation location to serve as an intake coordinator between the Dr. the patient.
- Handled confidential documents in an organized fashion according to established protocol.
- Processed medical claims to ensure timely reimbursement from insurance carriers using advanced billing software and electronic health records.
- Collaborated closely with other departments to resolve claims issues.
- Verified the accuracy of claim data prior to submission to insurance carriers.
- Maintained compliance with HIPAA regulations throughout the billing process consistently.
Billing Specialist
Vituity
Ontario, CA
03.2018 - 12.2021
- Performed data entry to maintain up-to-date records.
- Knowledge of Commercial, HOMs, Medicare, Workers Compensation payers.
- Verified insurance coverage and identified appropriate third-party payers to ensure accurate billing.
- Transfer balances to correct payers.
- Reviewed and verified insurance claims for accuracy and compliance, minimizing potential claim denials.
- Responded to customer inquiries regarding billings, payments, and account status to enhance customer satisfaction.
- Complied with all HIPAA Privacy and Security regulations to protect patients' medical records and information.
Medical Records Specialist
Neuroscience Institute
Pomona, CA
02.2017 - 03.2018
- Organize and manage patients' health information data.
- Ensure paperwork is properly filled out.
- Verify accuracy and accessibility of files.
- Ensure all files are secure.
- Answered incoming phone calls and scheduled patient appointments efficiently.
- Contacted patients to provide appointment reminders, enhancing attendance rates.
- Rescheduled patient appointments efficiently.
- Facilitated patient check-in and check-out procedures while managing their orders.
- Communicate with physicians and other healthcare professionals to clarify diagnoses or to obtain additional information.
Education
Certificate of Completion - Medical Billing
UEI College
Ontario, CA02-2011
High School Diploma -
Chaffey High School
Ontario, CA06-2010
Skills
- Medical billing
- Patient data entry
- HIPAA compliance
- Data entry accuracy
- Excel
- Word
- Microsoft Outlook
- Bilingual English/Spanish
- Effective communication
- Customer service
- Detail-oriented
- Detail orientation
Timeline
Administrative Assistant/ Medical Biller
Disabled Workers Advocates
06.2022 - Current
Billing Specialist
Vituity
03.2018 - 12.2021
Medical Records Specialist
Neuroscience Institute
02.2017 - 03.2018
Certificate of Completion - Medical Billing
UEI College
High School Diploma -
Chaffey High School