FERNI SANCHEZ
Medical and Dental Billing Specialist
Bellingham,WA
Summary
Versatile professional serves as first point of contact for patients by verifying insurance, handling paperwork and preparing records. Patient-oriented and helpful candidate familiar with MS Office and EHR systems coupled with knowledge of medical terminology. Committed to providing personalized service and quality patient care.
Overview
9
9
years of professional experience
Work History
Billing Specialist
Interfaith/Unity Care NW
06.2015 - 05.2017
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Examined patients' insurance coverage; copay, deductible, coinsurance, coordination-of-benefits, in-network, out-of-network, and limitations utilizing various payer insurance portals. Documented all details researched in patient account.
- Maintained strict confidentiality of patient information by adhering to HIPAA regulations, safeguarding sensitive data from unauthorized access or use.
- Educated patients on their medical and dental insurance benefits and coverage options, empowering them to make informed decisions regarding their medical care expenses.
- Precisely evaluated and verified patient and guarantor benefits and eligibility.
- Handled account payments and provided information regarding outstanding balances.
- Enhanced revenue collection through diligent follow-up on unpaid dental claims and denials with insurance companies.
- Analyzed Explanation of Benefits forms to verify correct billing of insurance carriers.
- Strengthened relationships with insurance companies through proactive communication, resulting in expedited claims processing and increased reimbursements.
Intake and Insurance Authorization Specialist
Fourth Corner Neurosurgical Associates
10.2009 - 09.2010
- Obtained authorizations and referrals from insurance payers for all patient office visits from primary care physician offices, private payers (HMO's, PPO's), Medicare, Medicaid, and Workers Compensation.
- Researched, reviewed and verified active insurance coverage details; copay, deductibles, in-network, out-of-network, coordination-of-benefits and demographic information for patient and/or guarantor, while utilizing various insurance portal resources and tools.
- Documented all patient eligibility and benefit details in practice management database, one to two weeks in advance from upcoming scheduled appointment.
- Facilitated patient flow during intake by notifying provider of the patient's arrival, being aware of delays, and communicating with patients and clinical staff.
- Served as insurance and coverage resource as needed, by working closely with front desk staff to provide smooth check-in process for the patients and providers.
- Entered patient demographics and scanned pre-registration information and state identification into EHR/EMR system.
- Acquired signed ABN's when necessary, during check-in process.
- Maintained strict confidentiality of patient information by adhering to HIPAA regulations, safeguarding sensitive data from unauthorized access or use.
Medical Receptionist/Charge Entries (Keyholder)
Clearvue Vision Center
04.2008 - 09.2009
- Responsible for capturing and entering patient demographics, financials, and clinical information into various information systems, including pre-registration and/or scanning information systems, in an accurate, complete, and timely manner
- Managed approximately 30-40 incoming calls (scheduling appointments, handling patient inquiries), emails and faxes per day from patients and physician's offices for two Optometrists.
- Handled charge entries and payment posting during patient check-out process.
- Collected all patient demographics, insurance information, and copay's
- Responsible for obtaining authorizations from insurance payers for patient visits
- Prepared patients for vision examination; assisted in testing for near and far acuity, depth perception, macula integrity, color perception, and visual field, utilizing ocular testing apparatus.
Education
Associate of Arts And Sciences - Transfer - Business
Whatcom Community College
Bellingham, WAMedical Billing and Coding Certificate - Health Administration
Whatcom Community College
Bellingham, WAMedical Front Office/Clerical certificate - Health Administration
South Seattle Community College
Seattle, WAPreventive Medicine Specialist - Public Health
Ft. Sam Houston Medical Academy
Ft. Sam Houston, TXSkills
- Verification of Eligibility and Benefits
- Verification of Pre-authorizations
- Patient Registration/Intake
- Medical terminology
- Medical and dental Billing
- Medical records management EMR/EHR
- Insurance Follow-up
- HIPAA Compliance/HIPAA Guidelines
- Centricity/Officemate/Provider One/One Health Port/Availity
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimeWork Location
RemoteImportant To Me
Career advancementWork-life balanceFlexible work hoursHealthcare benefitsWork from home optionPaid time offPaid sick leave401k matchStock Options / Equity / Profit SharingCompany CulturePersonal development programsLanguages
English
Full Professional
Interests
Art; painting, drawing, sewing
Camping
Community volunteer work
Air hockey
Cooking and baking
Vintage shopping
Remote work
Timeline
Billing Specialist
Interfaith/Unity Care NW
06.2015 - 05.2017
Intake and Insurance Authorization Specialist
Fourth Corner Neurosurgical Associates
10.2009 - 09.2010
Medical Receptionist/Charge Entries (Keyholder)
Clearvue Vision Center
04.2008 - 09.2009
Associate of Arts And Sciences - Transfer - Business
Whatcom Community College
Medical Billing and Coding Certificate - Health Administration
Whatcom Community College
Medical Front Office/Clerical certificate - Health Administration
South Seattle Community College
Preventive Medicine Specialist - Public Health
Ft. Sam Houston Medical Academy
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