Elizabeth Leyva
Covina,CA
Summary
Billing & Eligibility Processor with a solid foundation in insurance verification and eligibility coordination. Experienced in supporting billing accuracy and ensuring compliance with healthcare regulations such as HIPAA. Familiar with claims processing workflows and medical coding standards including CPT and ICD-10. Known for strong attention to detail, clear communication with members and providers, and a commitment to maintaining accurate documentation in a collaborative team environment.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Billing & Eligibility Processor
Pacific SouthWest Administrators
08.2022 - Current
- Verify insurance eligibility coverage and benefit details for members and providers.
- Document insurance details and authorization needs accurately, adhering to regulations.
- Identify and resolve discrepancies in insurance information, enhancing accuracy.
- Contribute to team goals by maintaining detailed records and facilitating smooth operations.
- Prepare and distribute eligibility reports, billing summaries, and other documentation as needed.
A/R Clerk
Brault
02.2020 - 04.2022
- Processed claims, verified benefits, resolved denials, ensuring accurate billing and compliance.
- Communicated with payers/providers, resolving claim issues, enhancing payment accuracy.
- Managed patient data under HIPAA, ensuring confidentiality and regulatory adherence.
- Assisted in claim coding with CPT/ICD-10, improving billing precision and efficiency.
General Merchandise Clerk
Stater Bros. Markets
01.2015 - 12.2019
- Managed clerical tasks and data entry, enhancing efficiency and accuracy.
- Ensured compliance with company regulations, maintaining operational integrity.
- Resolved customer inquiries promptly, boosting customer satisfaction and loyalty.
- Met or exceeded productivity standards to produce desired team and individual results.
- Backed up cashier staff during heavy customer flows to prevent unnecessary service delays.
Education
High School Diploma -
Covina High School
Covina, CACertificate - Medical Billing & Coding, HIPAA Compliance
Hacienda La Puente Adult School
Skills
- Insurance Eligibility & Benefit Verification
- CPT & ICD-10 Coding Knowledge
- HIPAA Compliance & Confidentiality
- Proficiency in MS Word, Excel, Outlook
- Problem-Solving
- Data entry proficiency
- Customer service
- Attention to detail
- Medical terminology
- Certified coding specialist (CCS)
- Research proficiency
- Records management
- Continuous improvement
Certification
Certified Coding Specialist (CCS), AHIMA
Timeline
Billing & Eligibility Processor
Pacific SouthWest Administrators
08.2022 - Current
A/R Clerk
Brault
02.2020 - 04.2022
General Merchandise Clerk
Stater Bros. Markets
01.2015 - 12.2019
High School Diploma -
Covina High School
Certificate - Medical Billing & Coding, HIPAA Compliance
Hacienda La Puente Adult School
Similar Profiles
Ricardo LopezRicardo Lopez
Customer Service Manager at Pacific Southwest AdministratorsCustomer Service Manager at Pacific Southwest Administrators
Elias Castillo GallegosElias Castillo Gallegos
BOBST MASTERCUT OPERATOR at Pacific Southwest ContainersBOBST MASTERCUT OPERATOR at Pacific Southwest Containers
Damon AlfaroDamon Alfaro
Apprentice Carpenter at Pacific Southwest StructuresApprentice Carpenter at Pacific Southwest Structures
Kevin RamirezKevin Ramirez
Stower at AmazonStower at Amazon
Denise TrosienDenise Trosien
Courier at Federal ExpressCourier at Federal Express