HEIDI A. Cordova
Sacramento
Summary
Highly skilled and detail-oriented Medical Billing and Payment Specialist with extensive expertise in accurately processing and managing diverse healthcare billing transactions. Proficient in analyzing complex Explanation of Benefits forms to ensure precise billing of insurance carriers and resolving denied claims through effective communication with insurance providers. Adept at examining patients' insurance coverage, deductibles, and payments, while proactively identifying and resolving billing discrepancies to streamline revenue cycles. Exceptional in communicating with patients for unpaid claims, delivering friendly follow-up calls to secure proper payments. Demonstrated ability to precisely complete claims paperwork, maintain organized documentation, and efficiently manage collections for outstanding bills.
Overview
12
12
years of professional experience
Work History
Payment Specialist
Luna Physical Therapy
Sacramento
09.2023 - Current
- Accurately enter insurance and patient payments into acloud-based revenue cycle management platform both electronically and manually.
- Reconcile daily payment batches and deposits with settlement reports to maintain accurate financial records.
- Assess EOBs, identify payment inaccuracies, zero payments, or short payments, and flag accounts for follow-up by the collections team.
- Utilize knowledge of various billing software and insurance payer portals to locate payments and EOBs.
- Respond to customer inquiries regarding invoices and payment issues, and assist in resolving billing discrepancies. Through an app hubspot CSM or telephone.
- The ability to navigate and operate the specific lockbox processing software, bank portals, and accounts receivable.
- Utilized secure file transfer protocols (FTP/SFTP) to download electronic payment data files from lockbox providers, ensuring accuracy, confidentiality, and compliance with security standards.
- Sorted incoming postal mail, scanned, and organized into payment, zero-payment, and correspondence batches for further processing.
Payment Poster
PBS - Professional Billing Service
Reno
06.2018 - 09.2023
- Company Overview: Radiology Revenue Cycle Management - Reno, NV
- Achieved seamless and error-free electronic and manual payment posting, streamlining the payment processing system and enhancing overall efficiency.
- Successfully managed and processed large volumes of data, ensuring timely and accurate payments and adjustments for diverse transactions.
- Identified overpayments through diligent analysis, resulting in the prompt processing of refunds for insurance carriers and patients, enhancing customer satisfaction.
- Spearheaded the processing of insurance and Medicare payments, consistently adhering to regulatory standards, and accelerating reimbursement cycles.
- Resolved billing variances with tenacity and precision, resulting in a significant reduction in outstanding accounts and improved cash flow.
- Reconciled the accounts receivable ledger with meticulous attention to detail, resolving discrepancies and maintaining accurate financial records.
- Spearheaded the generation of comprehensive monthly accounts receivable reports for management, facilitating informed decision-making and strategic planning.
- Radiology Revenue Cycle Management - Reno, NV
Medical Billing Specialist
PC Inc.
Anchorage
11.2014 - 05.2018
- Company Overview: Anchorage, AK
- Streamlined medical billing processes, accelerating the revenue cycle and reducing outstanding accounts and reimbursement times.
- Implemented rigorous quality control measures, resulting in a significant decrease in billing errors and an improved clean claim submission rate.
- Successfully resolved complex billing issues, leading to a decrease in denied claims and an increase in successful claims reimbursement.
- Optimized electronic billing systems, enhancing billing accuracy and reducing processing time.
- Negotiated with insurance carriers for optimal payment rates, resulting in increased collections and improved revenue generation.
- Conducted detailed analysis of complex Explanation of Benefits forms, ensuring accurate billing of insurance carriers and minimizing billing errors.
- Thoroughly examined patients' insurance coverage, deductibles, and insurance carrier payments, resulting in precise and timely billing submissions.
- Collaborated with healthcare providers to implement effective patient payment plans, leading to a decrease in delinquent patient accounts.
- Anchorage, AK
Medical Billing Specialist
Alaska Billing Services
Anchorage
08.2013 - 11.2014
- Company Overview: Anchorage, AK
- Facilitated seamless communication between patients, insurance companies, and the billing office, resulting in swift resolution of denied claims through proactive resubmissions.
- Conducted thorough examinations of patients' insurance coverage, deductibles, and insurance carrier payments, ensuring accurate billing submissions and timely reimbursement.
- Implemented effective communication strategies with patients for unpaid claims across various account types (HMO, PPO, private), leading to improved payment compliance and enhanced patient satisfaction.
- Analyzed complex Explanation of Benefits forms with precision, guaranteeing correct billing for insurance carriers and minimizing potential errors.
- Demonstrated exceptional skills in benefits evaluation and eligibility verification, ensuring accurate and efficient billing processes.
- Proactively identified and resolved patient billing and payment issues, contributing to reduced billing disputes and improved revenue collection.
- Maintained precise and organized claims paperwork, documentation, and system entry, ensuring efficient and accurate processing of insurance claims.
- Collaborated effectively with other departments to resolve claims issues, promoting a cohesive and streamlined workflow for optimal claim resolution.
- Developed and updated collections tracking spreadsheet, providing a comprehensive and well-organized payment information system.
- Successfully managed collections claims for unpaid bills against estates of debtors, showcasing exceptional negotiation skills and efficient payment processing from insurance companies.
- Anchorage, AK
Education
High School Diploma -
Dimond High School
Anchorage, AKSkills
- Insurance Billing Software
- Electronic Health Records (EHR)
- Explanation of Benefits (EOB)
- Insurance Verification
- Accounts Receivable
- Medical Billing Compliance
- Claims Submission
- Manual & Electronic Posting
- Denial Management
- Interpersonal Communication
- Revenue Cycle Management
- Proficient in ICD10
Timeline
Payment Specialist
Luna Physical Therapy
09.2023 - Current
Payment Poster
PBS - Professional Billing Service
06.2018 - 09.2023
Medical Billing Specialist
PC Inc.
11.2014 - 05.2018
Medical Billing Specialist
Alaska Billing Services
08.2013 - 11.2014
High School Diploma -
Dimond High School
Similar Profiles
Liliana MasiasLiliana Masias
Physician Relations Manager at Luna Physical TherapyPhysician Relations Manager at Luna Physical Therapy
Emely CubiasEmely Cubias
Physical Therapist at Luna Physical TherapyPhysical Therapist at Luna Physical Therapy
William RenkasWilliam Renkas
Physical Therapist at Luna Physical TherapyPhysical Therapist at Luna Physical Therapy
Shelly ShelferShelly Shelfer
Senior Therapy Network Specialist at Luna Physical TherapySenior Therapy Network Specialist at Luna Physical Therapy
Adrian ValenciaAdrian Valencia
Paraeducator/Preschool Afterschool Care Volunteer at Yuba City Unified School DistrictParaeducator/Preschool Afterschool Care Volunteer at Yuba City Unified School District