Gloria Ponticelli
Westlake Village,CA
Summary
Leveraged 11+ years of experience to manage medical coding and billing operations, focusing on efficient denial resolution and claim submissions.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Certified Professional Biller and Coder
Foot & Ankle Concepts, Inc.
Oxnard, CA
06.2025 - Current
- Processed and submitted medical claims using advanced billing software.
- Ensured accurate coding of procedures and diagnoses for optimal reimbursement.
- Reviewed patient accounts to resolve discrepancies and improve billing accuracy.
- Collaborated with insurance providers to address claim denials and appeals.
- Trained new staff on billing protocols and software functionalities.
- Developed streamlined workflows to enhance billing efficiency and reduce errors.
- Mentored junior billers, fostering professional growth and improving team performance.
- Checked insurance eligibility by making appropriate phone calls and conducting research on services rendered.
- Kept all patient information secure and confidential.
- Executed billing tasks and recorded information in company databases.
- Determined proper codes for medical records and patient services.
- Provided exceptional customer service in handling billing inquiries, resolving disputes promptly and professionally.
- Followed up with appropriate parties to obtain prompt payments.
- Reduced billing errors by implementing strict policies and systematic procedures.
- Managed a high volume of invoices, prioritizing workload to meet deadlines and maintain cash flow.
- Increased revenue through timely processing of invoices and thorough follow-up on outstanding payments.
- Generated monthly billing and posting reports for management review.
Medical Coder and Biller/Billing Department
General Surgery Medical Group of Ventura County
01.2019 - Current
- Code E/M services for our surgeon’s hospital rounds for both outpatient and inpatient hospital stays as well as for the emergency department visits using all the necessary guidelines. Code and assign the most accurate and appropriate CPT codes for any procedures and surgeries performed. Abstract and assign the diagnosis codes to the highest specificity obtained from the dictation of the physicians. Billing and claims submission for the services coded as well as claims follow up. Appealing any denials and correcting and resubmitting any claims as needed. Post insurance payments to patient accounts. Post over the counter patient payments and apply any adjustments necessary. Assist with patient collections via contacting patient and obtaining payments for past due amounts.
Medical Biller- Coder/Data Entry Specialist
Alamar Healthcare Inc.
Camarillo, CA
01.2015 - 01.2019
- Assisted in the transition from Coding ICD 9 CM to ICD 10CM. In the AdvancedMD and Aprima software, bill office, hospital, Skilled Nursing Facility, and STCC Sub Acute visits and labs/vaccines. Data enter demographics, confirm patient insurance eligibility. Correcting and providing Quest Diagnostics missing billing information. I also data enter both doctors’ notes for Skilled Nursing Facilities, home visits, and sub acute visits, along with coding all of the appropriate diagnoses. On a daily basis I post and allocate correctly the cash, check, and credit card over the counter payments. I also have experience with the responsibilities of a very busy front office such as filing, telephone calls, making office, radiology and lab appointments. Annually I achieve and recertify my title as a National Certified Insurance Coding Specialist with the NCCT. Currently I am a member and studying the AAPC materials to sit for the CPC exam in 2018.
Education
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Conejo Valley Adult School
Thousand Oaks, CA09.2015
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Watterson College Pacific
Oxnard, CA07.1991
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Oxnard High School
Oxnard, CA09.1990
Skills
- ICD-10-CM
- ICD-10- PCS
- CPT
- HCPCS
- Inpatient Coding
- Outpatient Coding
- MS Excel
- MS Outlook
- MS Word
- Medical Terminology
- HIPAA
- EOB/RA Posting & Analysis
- Appeals process
- Collections
- Denial Resolution
- Insurance Follow-up
- Confidentiality
- UHDDS
Certification
- Certified Professional Coder – American Academy of Professional Coders (AAPC) – 2018
- Certified Professional Biller – American Academy of Professional Coders (AAPC) 2021
- Certified Inpatient Coder – American Academy of Professional Coders (AAPC) - 2023
- Medical Billing and Coding Specialist, Conejo Valley Adult Education, Thousand Oaks, CA – September 2015
- Medical Assisting, Watterson College Pacific, Oxnard, CA – July 1991
Timeline
Certified Professional Biller and Coder
Foot & Ankle Concepts, Inc.
06.2025 - Current
Medical Coder and Biller/Billing Department
General Surgery Medical Group of Ventura County
01.2019 - Current
Medical Biller- Coder/Data Entry Specialist
Alamar Healthcare Inc.
01.2015 - 01.2019
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Conejo Valley Adult School
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Watterson College Pacific
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Oxnard High School