Felicia Romo
Medical Billing Director
Seagoville,TX
Summary
Certified Billing Director with over six years of experience leading home health revenue cycle operations and managing approximately $14.5M in annual claims volume. CPC and CPB certified with a strong track record of maintaining near-zero denial rates and consistently achieving a 100% clean claim submission rate.
Overview
6
6
years of professional experience
2
2
Certifications
Work History
Medical Billing Director
Lala Healthcare Solutions
Dallas, TX
11.2019 - 02.2026
- Directed full-cycle home health billing operations, overseeing approximately $280K in weekly claims volume (~$14.5M annually).
- Personally performed high-volume claim billing while supervising a 2-person team, ensuring accuracy and timely submission.
- Maintained a consistently clean accounts receivable portfolio with near-zero denials and minimal claim rejections.
- Achieved sustained first-pass claim acceptance through proactive eligibility verification, coding accuracy, and payer compliance review.
- Verified patient insurance eligibility and benefits prior to service to prevent avoidable denials.
- Obtained and managed prior authorizations in alignment with payer requirements and coverage limitations.
- Managed AR follow-up, denial resolution, and appeals for Medicare, Medicaid, and commercial insurance claims.
- Conducted routine audits of billing workflows within KanTime and payer portals to validate claim integrity and reimbursement accuracy.
- Maintained and corrected visit records within the TMHP EVV system to ensure compliance with Texas Medicaid regulations.
- Ensured accurate Medicaid billing in accordance with state and payer-specific reimbursement policies.
Education
High School Diploma -
W.W Samuell
Dallas, TXSkills
- Bilingual
- Revenue Cycle Management
- Claims Submission & Follow-Up
- Medicaid & Commercial Payers
- Texas Medicaid & TMHP Billing
- EVV Visit Maintenance (TMHP)
- Patient Authorizations
- Insurance Verification & Eligibility
- KanTime EMR
- Availity
- Compliance & Internal Auditing
- Home Health Billing & Reimbursement
Certification
CPB-Certified Professional Biller
CPC-Certified Professional Coder
Languages
Spanish
Professional Working
English
Native or Bilingual
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Medical Billing Director
Lala Healthcare Solutions
11.2019 - 02.2026
High School Diploma -
W.W Samuell