Summary
Overview
Work History
Education
Skills
Technologysummary
Timeline
Generic

Irene Munguia

Humble,TX

Summary

Detail oriented quality focused professional medical billing and medical authorizations. Successful track record handling complicated assignments. Highly experienced in reconciling insurance and patient payments, patients financial estimates and resolving account disputes. In Primary Care, OBGYN, Urology, Optometry, General Surgery, Dermatology, Hematology, Oncology and Infusion Dedicated to maintaining strict patient confidentiality.

Overview

20
20
years of professional experience

Work History

Ambulatory Service Representative II

Kelsey-Seybold
03.2021 - Current
  • Reviewed account information and explained charges and other related inquiries from patients and insurance carriers in person or via telephone.
  • Verified patient insurance eligibility and benefits.
  • Create OB global maternity estimates and review with patients.
  • Documented actions in system to maintain patient history and billing files.
  • Established payment arrangements according to policies, referring issues to supervisor.
  • Informed patient of self-pay and bad debt balances owed to facility.
  • Applied administrative knowledge and courtesy to explain procedures and services to patients.
  • Answered incoming calls.
  • Processed payments using cash and credit cards, maintaining accurate records of transactions.
  • Provide patients genetic testing benefits and review financial responsibilities.
  • Offered simple, clear explanations to help patients and families understand medical benefits and financial responsibilities.
  • Provided excellent customer service to patients and medical staff.
  • Facilitated communication between patients and various departments and staff.
  • Responded to inquiries by directing calls to appropriate personnel.
  • Greeted and assisted patients with check-in procedures.
  • Verified patient insurance eligibility and entered patient information into system.
  • Delivered support to medical staff in completion of patient paperwork.

Patient Account Analyst

Kelsey-Seybold
06.2004 - 04.2017
  • Experienced billing in Primary Care, Hematology, Oncology and Infusion
  • Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts
  • Insure accuracy of insurance claims
  • Verify correct ICD-10, and CPT codes for Primary Care, Hematology, Oncology and Infusion
  • Assign ICD-10 to physicians’ diagnosis and insure correct level of service and various other CPT codes
  • Follow up on claims and aging accounts
  • Re-submit insurance claims as necessary
  • Knowledgeable in timely filing restrictions for insurance payers
  • Understanding in compliance with HIPAA regulations
  • Performed insurance verification, pre-certification, and pre-authorization.

Education

Quarterly Company I-Learns -

Lone Star Community College
04.2024

Graduate -

Mac Arthur High School
05.1984

Skills

  • ICD-10, CPT, & Medical Terminology
  • Medical Insurance/ HMOs and Medicare
  • Excellent Interpersonal Skills
  • Excellent Phone Skills
  • Insurance & Patient Aging
  • HIPAA Compliance
  • Medical Billing
  • Medical Authorizations
  • Patient Financial Assistance
  • Gathering Information from Patients
  • Communicating to Patients and Families
  • Documenting and Recording Information
  • Benefits Explanation
  • Payment Collection
  • Insurance verifying

Technologysummary

  • Experienced in, MS Office (Word, Excel, Outlook)
  • Epic System
  • Electronic Medical Records

Timeline

Ambulatory Service Representative II

Kelsey-Seybold
03.2021 - Current

Patient Account Analyst

Kelsey-Seybold
06.2004 - 04.2017

Quarterly Company I-Learns -

Lone Star Community College

Graduate -

Mac Arthur High School

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Irene Munguia