IVELISE FIGUEROA
Nutley,NJ
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
25
25
years of professional experience
Work History
Senior Medical Billing Specialist
MEDHEALTH FINANCIAL SERVICES
Woodbridge, NJ
02.2021 - Current
- Analyzed patient accounts for accuracy and completeness of documentation and billing information.
- Performed data entry into electronic health records system for billing purposes.
- Resolved discrepancies between charges billed and payments received from insurance companies or other third-party payers.
- Reviewed claims rejections and denials to determine appropriate action needed for resolution.
- Processed appeals on denied claims as necessary.
- Responded to inquiries from providers regarding claim status, reimbursement rates.
- Provided training and support to staff members on medical billing processes.
- Reviewed payment plans with patients according to established protocols.
- Worked collaboratively with the finance team to ensure timely completion of month end closing tasks related to medical billings.
- Applied HIPAA privacy and security regulations while handling patient information.
- Submitted appeals using provider portals and phone communication.
- Monitored past due accounts and pursued collections on outstanding invoices.
- Developed strong professional rapport with vendors and clients.
- Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
- Managed all payments processing, invoicing and collections tasks.
Senior Medical Biller
Origin Healthcare Solutions
Rutherford, NJ
10.1998 - 02.2021
- Reviewed and corrected medical billing documents for accuracy prior to submission.
- Analyzed patient records, insurance information, and medical coding data to ensure proper reimbursement from insurance companies.
- Prepared monthly reports detailing accounts receivable status, denials, refunds, and adjustments.
- Submitted appeals to insurance carriers on denied claims.
- Trained other staff members in medical billing processes and procedures.
- Worked collaboratively with providers, coders, billers, auditors, and finance team members as needed.
- Applied HIPAA privacy and security regulations while handling patient information.
- Submitted appeals using provider portals and phone communication.
- Organized information for past-due accounts and transferred to collection agency.
- Answered customer questions to maintain high satisfaction levels.
- Managed all payments processing, invoicing and collections tasks.
- Performed accurate and fully compliant monthly closing processes, accruals and journal entries.
Education
DIPLOMA - Medical Assisting
HOHOKUS SCHOOL OF MEDICAL SCIENCES
Ramsey06.1996
Skills
- Account Reconciliation
- HIPAA Compliance Certification
- Claims Review
- Billing and Collection Procedures
- Critical Thinking
- Medical Record Security
- Electronic Health Record Software
- Payment Posting
- Account Management
- ICD-10
- Data Entry
- Data Analysis
- Invoice Processing
- Medical Terminology
- Account Follow-Up
- Customer Service
- Electronic Claims
- Clerical Support
- Teamwork and Collaboration
- Work Prioritization
Languages
Spanish
Professional
References
References available upon request.
Timeline
Senior Medical Billing Specialist
MEDHEALTH FINANCIAL SERVICES
02.2021 - Current
Senior Medical Biller
Origin Healthcare Solutions
10.1998 - 02.2021
DIPLOMA - Medical Assisting
HOHOKUS SCHOOL OF MEDICAL SCIENCES
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