Edna Lopez
Lubbock,TX
Summary
Knowledgeable Medical Biller with eye for detail and commitment to accurate work. Bilingual professional with expertise submitting medical claims to insurance carriers. Fluent in Spanish. Expert Medical Biller successful in fast-paced, high-volume medical offices. Competent medical billing professional manages busy medical office and delivers excellent customer service to patients.
Diligent Coding and Reimbursement Specialist with strong understanding of medical coding and reimbursement processes. Proven ability to accurately code medical procedures and diagnoses, ensuring optimal reimbursement and compliance. Demonstrated expertise in utilizing coding software and maintaining up-to-date knowledge of industry regulations.
Overview
22
22
years of professional experience
Work History
Coding & Reimbursement Specialist
Texas Tech Health Science Center
07.2023 - Current
- Served as a resource for colleagues regarding complex coding situations, offering guidance based on extensive knowledge of industry best practices.
- Developed strong relationships with payers, ensuring smooth resolution of any disputes or appeals related to claim denials.
- Maintained compliance with federal regulations, including HIPAA privacy rules, by implementing strict data handling procedures within the department.
- Collaborated with healthcare providers to clarify diagnoses, treatment plans, and other patient information necessary for proper coding and billing practices.
- Analyzed trends in denied claims to identify patterns and develop targeted strategies for improvement moving forward.
- Enhanced team productivity by providing ongoing training in ICD-10-CM, CPT, and HCPCS code sets as needed.
- Ensured timely reimbursements by efficiently processing high volumes of insurance claims in a deadline-driven environment.
- Improved coding accuracy through comprehensive review of medical documentation and application of industry guidelines.
Medical Billing Associate
Texas Tech Physicians Of Lubbock
03.2018 - 07.2023
- Posted payments and collections on regular basis.
- Gathered information from multiple sources to simplify billing and organize accounts.
- Collected payments and applied to patient accounts.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Answered constant flow of customer calls with minimal wait times.
- Communicated with management when customer issues escalated and worked to find resolutions.
- Educated customers about billing, payment processing and support policies and procedures.
Medicare Part D Customer Care Representative
United Healthcare Insurance
06.2017 - 12.2017
- Processing claims/sending members their medications through mail order.
- Enrolling member for Medicare Part D/prescription drug plan
- Following HIPAA privacy law/guidelines
- Leveraged sales expertise to promote products and capitalized on upsell opportunities.
- Regularly exceeded daily sales and product add-on quotas.
Customer Service Representative
Convergys Corporation
07.2003 - 12.2017
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Consulted with outside parties to resolve discrepancies and create effective solutions.
- Regularly exceeded daily sales and product add-on quotas.
- Answered constant flow of customer calls with minimal wait times.
- Collected customer feedback and made process changes to exceed customer satisfaction goals.
- Recommended products to customers, thoroughly explaining details.
- Leveraged sales expertise to promote products and capitalized on upsell opportunities.
Education
High School Diploma -
Lamesa High School
Lamesa, TX05.1996
Skills
- Client communication
- Billing data accuracy verification
- Invoice management
- Financial transaction recording
- Strong written communication skills
- Skilled in using Microsoft Office tools
- Proficient in 10-key input
- Effective task management
- Spreadsheet data organization
- Comprehensive documentation skills
- Enthusiastic approach
- Proficient in bilingual communication
- Claims processing
- Insurance verification
- Denial management
- Medical coding expertise
- Revenue cycle management
- Data entry
- Proficiency in Athena, Zoom, Cerner
- Medical billing
- Teamwork and collaboration
- Problem-solving
- Microsoft Excel
- Insurance billing
- Electronic health records
Languages
Spanish
Professional Working
Timeline
Coding & Reimbursement Specialist
Texas Tech Health Science Center
07.2023 - Current
Medical Billing Associate
Texas Tech Physicians Of Lubbock
03.2018 - 07.2023
Medicare Part D Customer Care Representative
United Healthcare Insurance
06.2017 - 12.2017
Customer Service Representative
Convergys Corporation
07.2003 - 12.2017
High School Diploma -
Lamesa High School
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