EVELYN VINDIOLA

• Records:
• Prepared charts for 6 providers weekly by obtaining and uploading all progress notes, tests and labs for upcoming appointments.
• Copying and sending out records to patients, insurance companies, other providers and court ordered subpoenas
• Customer Service:
• Answer phones and assist patients with making/canceling appointments,
• Referrals:
• Submitted/Obtaining online referral and authorization requests for appointments, tests and in office procedures.
• Follow-up on pending referrals/authorizations by submitting any needed documentation to show medical necessity.
• Medical Coding:
• Read OP reports to determine CPT, ICD-10 and HCPC codes for billing
• Medical Billing and Follow-Up:
• Verify insurance addresses and add to patients files
• Data enter Insurance ID and responsible parties information
• Send claims out paper/electronically (primary and secondary)
• Make out going calls to insurance companies to follow-up on outstanding claims
• Send resubmission claims or Appeals
• Work incoming insurance correspondences to send any documentation to expedite claims processing
• Self-motivated, with strong sense of personal responsibility
• Worked effectively in fast-paced environments
• Paid attention to detail while completing assignments
• Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
• Processed medical records requests from outside providers according to facility, state, and federal law.
• Communicated effectively with staff, patients, and insurance companies by email and telephone.

• Worked off of weekly reports making out going calls to various insurance companies to get claim status and adjudication information.
• Worked insurance correspondence to send out any documentation needed to expedite claims processing
• Sent resubmissions, appeals and did state fair hearings also set up peer to peer reviews.
• Reviewed insurance contracts to make sure claims were paid correctly.
• Worked with insurance company representatives on projects for claim denial trends.
• Billed primary and secondary claims electronically and paper
• Reviewed EOB/ERA's for correct reimbursement, contractual adjustments and patient responsibility.
• Worked negative balance remits and insurance recoupment

remits

• Worked effectively in fast-paced environments
• Used critical thinking to break down problems, evaluate solutions and make decisions
• Entered patient demographic and insurance data into electronic medical record system.

• Full cycle billing and follow-up
• Data entry entered all patient information and insurance information.
• Posted payments and wrote off any adjustments
• Helped with getting new doctors credentialed with all contracted insurance companies
• Answered phones and assisted patients with any insurance questions or concerns.
• Reviewed insurance contracts to make sure providers were paid best rates possible.
• Went to insurance company meetings to insure our practice was up to date on any changes that could effect claim reimbursement.
• Was in charge of all access to insurance websites and portals
• Billed primary and secondary claims electronically and paper
• Checked electronic claim reports daily to make sure claims were accepted or if denied fixed any issue and re-billed
• Sent appeals and did state fair hearings
• Worked credit balance accounts to be refunded back to insurance companies or patients.
• Trained new employees and created office procedure manual with detailed job descriptions
• Helped front desk with patients that had insurance questions or had patient payments
• Calculated all surgery copays, coinsurance's and deductibles for patients responsibility
• Paid attention to detail while completing assignments
• Researched billing errors and discrepancies to initiate corrective action.