Denise Ortega

Submitted appeals.

Review correspondence received from payor.

Trained staff on a weekly basis

Attended seminars

Coded and processed Out of network billing for Bariatrics, EGD, and Hiatal Hernia surgeries and office visits.

Reviewed and validated accuracy of charges including dates of service, services provided, location and provider signature.

Reviewed EDI/ERA reports.

Negotiated claims with vendors.

Prepared/submitted emergent cases through the State Arbitration (Maximus)

Prepared/submitted cases through the Federal Arbitration process.

Processed appeals for all non-paid or under paid claims.

Submitted medical records on a timely matter when requested from Payor.

Generated A/R reports and followed up on all claims.

Explained patient benefits and prepared payment plans.

Generated patient statements and follow up calls on patient balance.

Trained all staff and held bi-weekly meetings.

Collaborated with doctor's to resolve complex cases.

Attended seminars and webinars.

• Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
• Conducted regular audits of billing records to ensure accuracy and completeness, enhancing overall financial performance for the practice.
• Entered invoices requiring payment and disbursed amounts via check, electronic transfer or bank draft.
• Prepared billing statements for patients and verified correct diagnostic coding.
• Processed out of network billing for Chiropractic, Acupuncture, and Physical Therapist.
• Prepared pip files for attorney's and negotiated balance when PIP case or Worker's Comp.
• Pre-certed MRI's and visits when needed.
• Communicated with claims adjuster for Worker's Comp Case
• Posted to patient's account all reimbursements from payor and generated any patient statements.
• kept track of office stats to reach monthly/yearly goals.
• Managed office staff, trained all staff, handled employee schedule and request for time off.
• Attended out of state seminars every two months on billing and office procedures.

• Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
• Prepared billing statements for patients and verified correct diagnostic coding.
• Filed and updated patient information and medical records.
• Collected payments and applied to patient accounts.
• Processed billing for out of network Chiropractic and Physical Therapy.
• Pre-certed visits for PIP insurance
• Prepared file for attorney and negotiated billing.
• Managed staff, trained new hire, Managed time off and PTO.
• Attended seminars and webinars for office procedures and billing.