Summary
Overview
Work History
Education
Skills
References
Languages
Timeline
Generic

Erika Romo

Snelling,CA

Summary


Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing and managing medical record information to obtain prior authorizations from insurance companies and ensure payment. Expertise in accurately confirming procedure codes and diagnosis codes for Home Health Referrals.

Overview

20
20
years of professional experience

Work History

Referral Clerical Specialist

Sutter Care at Home
09.2020 - Current
  • Clerical support to the Referral Center for Sutter Care at Home
  • Assisting the Clinical Referral Specialist and Supervisor to ensure the effective communication between Referral Center, Staff, Referring Physicians, Board and Care Facilities, Skilled Nursing Facilities, Patients, Families, Hospice Site Staff, Patient Care Liaisons, other referral sources and SCAH Organization
  • Manages the referral center phone calls and documenting hospice referrals, scheduling initiation visits and Skilled Nursing Assessments, communicated with sites regarding new referrals, and supports statistics and reporting functions for the Referral Center
  • Creating and Completing charts for Home Health Referrals including Insurance Checks, ICD-10 DX Coding and reviewing Charts for final processing.

Patient Services Representative

Sutter Gould Medical Foundation
01.2019 - 09.2020
  • Registered Patients for Specialties Departments to include Cardiology, General Surgery, Gastroenterology
  • Checked for Authorizations and Verified Eligibility prior to Registration

Customer Service Representative

Health Plan Of San Joaquin
07.2018 - 01.2019
  • Call Center Environment, appeals status, authorization status, eligibility claims, Understanding and educating processes
  • Answering all questions in regards to Health Plan Of San Joaquin Medicaid

Registration Representative, Unit Coordinator

Doctors Medical Center
09.2011 - 03.2018
  • Answering Phones, Preparing Schedules Verifying Eligibility Registering Patients for Procedures, Appointments Discharging Patients, Answering Call Lights, Preparing Charts, Keeping Track Of Census

Medical Biller Coder

Precision Medical Billing
07.2008 - 09.2011
  • Evaluated all medical records on a daily basis and ensured compliance to ICD -9 coding
  • Analyzed medical claims and identified any coding errors in information
  • Coordinated with provider and claim department to process claims
  • Placed Collection Calls, Several A/R Reports for all Payers Took Payments From Patients Customer Service and Processed All Incoming Mail

CSR, Receptionist, Appointment Clerk

Kaiser Permanente
10.2005 - 06.2008
  • Took Inbound Calls (Call Center Environment), Verified Member Eligibility, Resolved Grievances
  • Provided Health Care Information To Members With Concerns, Registered Patients in Radiology, Scheduled and Confirmed Appointments, Sent Messages to Referring Providers

Medical Billing Specialist

Med America Billing Services Inc.
05.2005 - 10.2005
  • Answer and resolve patient billing inquiries
  • Send secondary claims upon processing of primary insurance
  • Monthly processing of Patient statements
  • Answer and resolve patient billing inquiries
  • Follow up on Insurance and patient aging
  • Re-submit insurance claims as necessary
  • Knowledgeable in timely filing restrictions, Ensure office practices are in compliance with HIPAA regulations

Education

CPC-A - CPC Coding Certification Course

AAPC
10.2024

Medical Billing and Coding Certificate -

Institute of Technology
Modesto, Ca
07.2011

Medical Terminology Course, Anatomy and Physiology Course

Santa Barbara City College
01.2007

High School Diploma -

Modesto High School
01.1999

Skills

    HIPPA Compliance Awareness

    Data Entry

    Medical Terminology

    Adaptability

    Organization

    Attention to Detail

    Medical Billing

    ICD-10

    Practicode

    CPT

References

Available Upon Request

Languages

Spanish
Full Professional

Timeline

Referral Clerical Specialist

Sutter Care at Home
09.2020 - Current

Patient Services Representative

Sutter Gould Medical Foundation
01.2019 - 09.2020

Customer Service Representative

Health Plan Of San Joaquin
07.2018 - 01.2019

Registration Representative, Unit Coordinator

Doctors Medical Center
09.2011 - 03.2018

Medical Biller Coder

Precision Medical Billing
07.2008 - 09.2011

CSR, Receptionist, Appointment Clerk

Kaiser Permanente
10.2005 - 06.2008

Medical Billing Specialist

Med America Billing Services Inc.
05.2005 - 10.2005

Medical Billing and Coding Certificate -

Institute of Technology

Medical Terminology Course, Anatomy and Physiology Course

Santa Barbara City College

High School Diploma -

Modesto High School

CPC-A - CPC Coding Certification Course

AAPC

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Erika Romo