Ivet Valdes Gomez
Insurance And Coding Specialist
Hialeah,FL
Summary
Insurance and Coding Specialist with 12.5 years of experience in Diagnostic X-ray, Ultrasound and Cardiology procedures. Loyalty, reliability, and strive to give 100% at not only the at job at hand but helping others for the benefit of the company always putting patient care in the forefront. Productive and diligent with passion for resolving discrepancies through attention to detail and creative problem-solving. Passionate about perpetuating company values through impeccable work ethic and drive.
Overview
15
15
years of professional experience
4
4
years of post-secondary education
1
1
Certification
Work History
Medical Billing Manager
Allied Mobile X-ray Inc.
Miami, FL
12.2009 - Current
- Verifying patients' eligibility and claim status using various platforms (Kareo, Availity, Change Healthcare, SPOT, and other Insurance specific sites)
- Obtain prior authorizations and single case agreements as needed.
- Update bi-annual Fee Schedules for over 50 individualized contracts using Medicare Allowable schedule.
- Experience with Medicare, Medicaid, Medicare replacement plans, and commercial insurance.
- Received and posted Explanation of benefits for review of errors, denials, adjustments, and correct reimbursements of payments.
- Analyze billing and claims for accuracy and completeness; submit claims to proper insurance carriers and follow up on any issues.
- Worked with customers to develop payment plans and bring accounts current.
- Supported Management with special projects and additional job duties.
- Submit appeals needed for denied procedures reimbursable based on AMA and CMS guidelines.
- Created claims for X-rays, Ultrasounds, and Cardiac Mobile procedures with accurate CPT and ICD-10 codes daily.
- Assisted in new payer creation in Billing software for Electronic claim submission, eligibility, and EFT payment.
Clerk/ Secretary
Baques Accounting
Hialeah, FL
01.2000 - 02.2002
- Personal and corporate accounting Sales tax form filling
- Data entry for monthly financial information for over 50 companies
- Created organizational system for all clients
- Answered phones and created appointments for clients
Education
Coding Specialist - Medical Coding And Billing Specialist
Florida Career College
Hialeah, FL 01.2009 - 12.2009
Certificate of Completion - Medical Billing And Coding Specialist
U.S. Career Institute
Miami, FL 08.2006 - 06.2007
Associate of Arts - Culinary Arts
Johnson & Wales University - North Miami
Miami, FL 02.2001 - 06.2003
Skills
Collections understanding
Revenue Generation
Relationship building and management
Reporting familiarity
Patient data compilation
Coding error resolution
Proficiency in Kareo, Availity, & Revenue Performance
Medical billing code accuracy
Good Telephone Etiquette
Organization and Time Management
Interpersonal Communication
Aging reports analysis
HIPAA regulation observance
CPC certification in progress
NCICS certified since 2009
Certification
Insurance and Coding Specialist
Timeline
Medical Billing Manager
Allied Mobile X-ray Inc.
12.2009 - Current
Insurance and Coding Specialist
12-2009
Coding Specialist - Medical Coding And Billing Specialist
Florida Career College
01.2009 - 12.2009
Certificate of Completion - Medical Billing And Coding Specialist
U.S. Career Institute
08.2006 - 06.2007
Associate of Arts - Culinary Arts
Johnson & Wales University - North Miami
02.2001 - 06.2003
Clerk/ Secretary
Baques Accounting
01.2000 - 02.2002