Evelyn Molina

· Revenue Cycle ARS for Stanford Children's Hospital, LPCH

· Completed in-depth research to investigate claims and resolve problems.

· A/R follow-up on delinquent accounts

· Working denials for professional services

· Medicaid/Medicare/Commercial Appeals, Redeterminations, Reconsiderations, all levels.

· SME Medi-Cal and Medi-Cal MCOs

· Training and onboarding new employees

· Daily briefings on revenue cycle status via Teams

· Special Projects as assigned

· Payment posting and processing - All payer types, Commercial, Medicaid, Medicare

· ERA and paper check posting

· Identifying and escalating underpaid or zero paid procedures to manager for review

Prepared and mailed invoices to customers, processed payments and documented account updates.

· Preparing, reviewing, and submitting claims electronically or by paper daily

· Resolving daily rejections on claims submitted to payers

· Following up on past due claims

· Working payer denials daily

· Identify and resolve patient billing questions and concerns

· Posting payments manually and automatically

· Working unpaid and rejected insurance claims

· Re-submitting and appealing claims to insurance carriers

· Following up on patient accounts

· Working on patient and insurance Accounts Receivable on a regular basis

· Resolving credit balances and account issues

· Verifying patient's insurance eligibility and benefits

· Back up for answering a multi-line telephone

· Scheduling appointments

· Greeted, scheduled, prepared charts and created accounts for new or establish patients

· Posted charges for three clinics with multiple insurances and hospital admissions

· Posted payments from multiple insurances and industrial companies

· Filed claims for worker's compensation and following up with A/R

· Submitted electronic claims weekly

· Collected Drug Test and preparing chain of custody forms for Industrial Companies

· Responsible for maintaining on-call and monthly doctors schedule for 5 different clinics

· Handled various administrative and clerical duties

· Trained new employees on Mysis/Tiger system

· Performed Eligibility and Verification for all payers

· Processing daily and monthly claims batches

· Trained new employees in the claims department

· Performed claim audits for all payers

· Responsible for performing various administrative and clerical duties

Assisted with A/P duties when assigned