Debra Mora
San Antonio
Summary
Results-driven Billing Manager with extensive experience in claims processing, denial management, and accounts receivable. Expertise in staff training and process optimization, leading to improved operational efficiency and reduced billing errors.
Overview
38
38
years of professional experience
Work History
Billing Manager
Women Partners in OBGYN
San Antonio, TX
01.2000 - Current
- Oversaw billing operations, ensuring accuracy and compliance with healthcare regulations.
- Streamlined billing processes, improving efficiency and reducing errors in patient invoicing.
- Managed accounts receivable, maintaining timely follow-up on outstanding payments.
- Trained and mentored billing staff, fostering a culture of continuous improvement and collaboration.
- Implemented new billing software, leading transition efforts and training staff on system usage.
- Reviewed billing problems, researched issues, and resolved concerns.
- Assigned appropriate ICD-10, CPT, and HCPCS codes to diagnoses and procedures.
- Maintained knowledge of current coding guidelines and regulations to ensure accuracy.
- Collaborated with healthcare providers to clarify documentation discrepancies.
- Trained junior coders on best practices and coding standards for accuracy.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
Medical Billing Specialist
Thomas Spann Clinic
Corpus Christi, TX
03.1988 - 12.1999
- Processed medical claims using advanced billing software to ensure timely reimbursement.
- Reviewed and verified patient insurance information for accuracy, minimizing claim denials.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Collected payments and applied to patient accounts.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
Education
Associate of Applied Business - Business Administration
Southern Business School
Corpus Christi, TX01-1989
Skills
- Personnel oversight
- Audit support
- Interest calculations
- Accounts receivable management
- Collections experience
- Claims processing
- Training and mentoring
- Staff training and development
- Staff training
- Medical billing expertise
- Denial management
- Collections
- Insurance verification
- Team building
Timeline
Billing Manager
Women Partners in OBGYN
01.2000 - Current
Medical Billing Specialist
Thomas Spann Clinic
03.1988 - 12.1999
Associate of Applied Business - Business Administration
Southern Business School