Deborah Sota
Peoria,AZ
Summary
Results driven Medical Biller with over 35 years of hands-on experience in account management, revenue generation and medical billing and coding. Accomplished in developing strategies to improve workflows and processes and actualizing procedures to enhance revenue generation. Demonstrated leadership skills guide teams towards success, optimize performance and sustain organizational success.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Billing Specialist/ Office Manager
Dr. E Mora
Phoenix, AZ
06.1998 - 04.2010
- Reviewed medical records to ensure accuracy of billing information and patient data.
- Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
- Calculated billing charges, prepared and submitted claims to insurance companies.
- Verified insurance coverage and identified third-party payers for billing purposes.
Medical Billing Specialist
Medical Specialists LTD
Phoenix, AZ
03.1996 - 06.1998
Medical Billing and Collections Specialist
Self Employed Southwest Billing Specialists
Peoria, AZ
11.2013 - 01.2024
- Verified patient insurance eligibility and coverage for medical services rendered.
- Reviewed, coded, and submitted claims to insurance companies and government payers.
- Followed up on unpaid or denied claims in a timely manner.
- Resolved billing discrepancies with insurance companies and patients.
- Communicated with patients regarding payment plans, overdue balances, and collections issues.
- Reconciled accounts receivable reports to ensure accuracy of payments received.
- Maintained detailed records of all billing activities in compliance with company policies and procedures.
- Processed credit card payments from patients for medical services rendered.
- Utilized various software programs to enter data into the system accurately.
- Generated monthly financial statements for review by management team.
- Analyzed account receivables aging report to identify delinquent accounts.
- Developed strategies to improve collection rates and reduce outstanding debt levels.
- Responded promptly to customer inquiries regarding billing disputes or discrepancies.
- Monitored changes in regulations related to healthcare billing practices.
- Tracked payments received from third-party payers such as Medicare and Medicaid providers.
- Assisted in preparation of annual audits by providing required documentation upon request.
- Collaborated closely with other departments such as clinical staff, front desk personnel., to ensure accurate coding of services provided.
- Implemented new technologies and processes that improved efficiency of billing operations.
- Participated in ongoing training sessions to stay abreast of changing industry trends and best practices.
- Prepared weekly updates on revenue cycle performance metrics.
- Provided technical support when needed during implementation of new systems or software upgrades.
- Managed daily workflow for the department including assigning tasks among staff members.
- Evaluated current collections process and identified areas where improvement is needed.
- Took billing calls, questions and concerns from patients and third party carriers.
- Entered patient charges and payments into electronic health records.
- Processed claims and forwarded information to Medicare, Medicaid and commercial insurance companies.
- Identified discrepancies and carrier issues regarding billing and reimbursements.
- Processed refund requests and reconciled deposit and patient collections.
- Oversaw daily collections and accounts receivable activities, developing robust strategies to maximize collections and reduce aged accounts.
- Corrected, completed and processed claims for payer codes.
- Attended provider meetings and workshops when appropriate.
- Sent incomplete or incorrect claims to supervisors for proper adjudication.
- Submitted claims to insurance companies.
- Collected, posted and managed patient account payments.
- Monitored past due accounts and pursued collections on outstanding invoices.
- Managed all payments processing, invoicing and collections tasks.
- Checked claims coding for accuracy with ICD-10 standards.
- Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
- Answered customer questions to maintain high satisfaction levels.
- Performed insurance verification, pre-certification and pre-authorization.
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
- Generated and distributed month-end statements for customers and resolved related concerns.
- Performed accurate and fully compliant monthly closing processes, accruals and journal entries.
Medical Billing and Collections Specialist/Office Manager
Fixing Feet Specialists
Sun City, AZ
04.2010 - 02.2014
- Verified patient insurance eligibility and coverage for medical services rendered.
- Researched complex billing issues involving multiple providers or services rendered over a period of time.
- Provided customer service support to patients who had questions about their bills or payments due.
- Generated monthly invoices for patients based on services provided according to established fee schedules.
- Assisted with the reconciliation of accounts receivable ledgers at month-end close process.
- Worked closely with clinical staff to ensure accurate coding practices were followed.
- Posted charges, payments and adjustments.
Education
Associate of Arts - Medical Billeting Medical Assistant Full Program
Southwest Medical Academy
Phoenix03.1983
Skills
- A/P and A/R Proficiency
- Microsoft Office
- Customer Relations
- Statement Preparation
- Collections
- Billing Practices
- Records Management
Certification
Certified Medical Coder ICD 10/ ICD 9/ CPT
References
References available upon request.
Timeline
Medical Billing and Collections Specialist/Office Manager
Fixing Feet Specialists
04.2010 - 02.2014
Billing Specialist/ Office Manager
Dr. E Mora
06.1998 - 04.2010
Associate of Arts - Medical Billeting Medical Assistant Full Program
Southwest Medical Academy
Medical Billing Specialist
Medical Specialists LTD
03.1996 - 06.1998
Medical Billing and Collections Specialist
Self Employed Southwest Billing Specialists
11.2013 - 01.2024