Prepared Authorization in the different medical portals such as UHC, Blue Shield, Blue Cross and other medical web-based portals
Set up new patient info in Allscripts to make sure they have current eligibility and benefits
Called patient(s) on late or unpaid payments and requested to update their current address for our files.
Reimbursement Representative
PROVIDENCE HOME CARE
Anaheim, CA
08.2022 - 10.2022
Daily tracking of Medicare NOE's/NOTR's
Identify bad debt and contractual allowances with attached documentation supporting request for write-offs
Document in computer system all phone calls and correspondence with payor source
Calculate accurate contractual write off on open accounts, utilizing appropriate write off codes
Resubmit claims not received by payor source, with verification of receipt
Timely follow up on open balance accounts.
Lead Reimbursement Representative
Amplus Group
Torrance, CA
02.2022 - 03.2022
Communicates with branches and other departments to assure resolution of reimbursement issues
Timely review of remittance Advice/Correspondence, take appropriate steps to appeal nonpayment of claims
Report to Manager on any reimbursement issues resulting to nonpayment.
Collection Analyst
KabaFusion
Cerritos, CA
10.2021 - 12.2021
Analyze and rectify claims issues with payers by timely follow up of claims status/payments
Handles collections call promptly with professionalism to payors and/or patients
Provide medical records, doctor and/or nurses notes along with the prescription and execute an appeal on denied EOB's
Reimbursement Representative
U. S. Renal Care
Long Beach, CA
09.2000 - 10.2020
Reviews EOB/EOMB's for proper reimbursement
Resolve electronic claim rejections and Explanation of Benefits denials in a timely manner
Follows up on unpaid/unresolved account balances., including claims rejected electronically, report to Manager on any reimbursement issues resulting in nonpayment.
Education
Associate degree in Business Administration - Business Admin
Compton Community College
Compton, CA
09.1977 - 06.1986
Skills
Epic
ICD-9
ICD-10
Medicare (10 years)
Cerner
Microsoft Excel (10 years)
Microsoft Word (10 years)
Microsoft Outlook (10 years)
Managed care (10 years)
Customer Support
Telephone Reception
Paperwork Processing
Certification
Medical Billing Certificate
Timeline
Reimbursement Representative
Cardiovascular Medical Group
02.2023 - 03.2023
Reimbursement Representative
PROVIDENCE HOME CARE
08.2022 - 10.2022
Lead Reimbursement Representative
Amplus Group
02.2022 - 03.2022
Collection Analyst
KabaFusion
10.2021 - 12.2021
Reimbursement Representative
U. S. Renal Care
09.2000 - 10.2020
Associate degree in Business Administration - Business Admin
Compton Community College
09.1977 - 06.1986
Medical Billing Certificate
Personal Information
Work Permit: Authorized to work in the US for any employer
Personal Information
Work Permit: Authorized to work in the US for any employer
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