IMELDA J. MARTINEZ
LANTANA,USA
Summary
Dedicated billing specialist with a strong foundation in medical billing and insurance claims management. Proficient in processing claims, resolving inquiries, and negotiating with insurance providers to enhance billing efficiency and patient satisfaction.
Overview
24
24
years of professional experience
Work History
Billing Specialist
Orthopedic Care Specialist
West Palm Beach, Florida
06.2014 - Current
- Managed insurance claims submissions and tracked payment statuses accurately
- Negotiated payment terms with insurance providers to facilitate timely reimbursements.
- Processed check payments and generated patient bills to ensure timely revenue collection.
- Responded to customer inquiries regarding billings, payments, and account status to enhance customer satisfaction.
- Record charges while assessing account and verify if any outstanding matters exist with insurance or patient.
- Process explanation of benefits through paper or insurance inquiries
Insurance Biller
Medreceivables Advisors
Deerfild Beach, FL
01.2011 - 06.2014
- Prepared and filed appeals for denied claims, ensuring timely follow-up with insurance companies
- Submitted and managed hospital claims to facilitate timely reimbursement
- Contacted insurance companies to resolve outstanding balances
- Expertise in insurance payment regulations including various reimbursement, coinsurance, deductibles, and contractual adjustments
Billing
Dermatology Associates
West Palm Beach, FL
01.2006 - 01.2011
- Prepare and submit appeals for denied claims to insurance carriers
- Followed up with insurance companies on open balances to expedite payments
- Collaborated with insurance providers to review explanation of benefits and secure necessary referrals.
- Applied knowledge of insurance payment regulations to ensure accurate reimbursement and compliance
- Address patient inquiries regarding billing through effective phone communication.
- coordinate with provider representatives to address claim concerns and projects
Billing
Steven D. Gelbard, M.D.
Pompano Beach, FL
01.2005 - 01.2006
- Prepares and submits appeals for denied claims to insurance carriers
- Follow up with insurance companies on open balances
- Verified patient insurance benefits to ensure coverage accuracy.
- Address patient phone inquiries regarding billing issues
- Managed high volume of incoming patient calls with effective communication.
- Work with E.O.B's and obtain referrals
- Schedule appointments for patients
Billing
Dermatology Associates
West Palm Beach, FL
01.2003 - 01.2005
- Collected payments from insurance companies to ensure timely revenue flow
- Submit reviews and appeals
- Addressed patient inquiries regarding billing issues to enhance customer satisfaction
- Coordinated with E.O.B's and obtained referrals to facilitate efficient claims processing
- Work with provider reps with claim issues and projects
Medical Records & Billing
Physician Billing and Financial Services
Boca Raton, FL
01.2002 - 01.2003
- Processed and submitted patient claims to insurance companies, ensuring timely reimbursement.
- Entered charges and coded MRI and NCV procedures to maintain accurate billing records.
- Organized and maintained patient records, including purging outdated files to ensure compliance.
- Coded and created new patient files for accurate record-keeping
- Answered phones to provide information and assistance
- Faxed requested information to attorney's office for legal purposes
- Knowledge of Florida law regarding the release of medical authorization.
Education
Certificate of Medical Coding Specialist -
Palm Beach Community Collage
Lake Worth, FL11-2002
Skills
- Claims management
- Billing expertise
- CPT
- ICD-9 & ICD-10
- Payment posting
- Claim submission
- Revenue management
- HIPAA
- Health management
- Current operating systems
- Microsoft Office
- Bilingual proficiency
Timeline
Billing Specialist
Orthopedic Care Specialist
06.2014 - Current
Insurance Biller
Medreceivables Advisors
01.2011 - 06.2014
Billing
Dermatology Associates
01.2006 - 01.2011
Billing
Steven D. Gelbard, M.D.
01.2005 - 01.2006
Billing
Dermatology Associates
01.2003 - 01.2005
Medical Records & Billing
Physician Billing and Financial Services
01.2002 - 01.2003
Certificate of Medical Coding Specialist -
Palm Beach Community Collage