Janeth Leal
Provider Account Manager
Rio Grande City,TX
Summary
Seasoned collaborator experienced in meeting needs, improving processes and exceeding requirements in team environments. Diligent worker with strong communication and task prioritization skills.
Overview
18
18
years of professional experience
Work History
Data Processing
Starr County Memorial Hospital
Rio Grande City, Texas
07.2012 - Current
- Located and corrected data entry errors and reported to management.
- Verified accuracy of data before transcribing.
- Sorted and processed incoming reports before putting data into processing software.
- Managed workflow scheduling, data entry and accuracy verification for large data projects.
- Denial Management-Assist Billing Clerks with denials
- Corrected data entry errors to prevent later issues such as duplication or data degradation.
- Increased data-entry productivity by maintaining detailed logs of data projects, identifying issues and improving them.
- Review Quarterly Insurance Changes
- Work with insurance recoupment
- Compliance/Revenue Integrity
- Answered data questions for company leaders as subject matter expert to enhance decision making.
- Double checked accuracy of hard copy paperwork and rectified any issues.
- Identified data entry errors and reported to necessary departments.
- Maintained ongoing communication with relevant departments to confirm accurate data delivery.
- Produced monthly reports using advanced Excel spreadsheet functions.
- Executed data verification to detect errors.
- Supported multiple departments with special projects.
- Created reports based on up-to-date data to inform business decisions.
- Reduced data errors by managing multi-step QA process.
Medical Insurance Biller
Starr County Memorial Hospital
Rio Grande City, Texas
04.2000 - 03.2008
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Collected payments and applied to patient accounts.
- Filed and updated patient information and medical records.
- Posted payments and collections on regular basis.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Trained new employees on multiple medical billing programs and data entry software.
- Liaised between patients, insurance companies and billing office.
- Orchestrated medical coding, payment posting, accounts receivables and collections.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Gathered information from multiple sources to simplify billing and organize accounts.
- Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
- Set up and maintained new electronic billing system.
- Delivered timely and accurate charge submissions.
- Managed billing calendar and scheduled claims for payments.
Education
Excel Intermediate ITSW 2029.M01 - General Office Services
South Texas College
Mcallen, TX02.2022
Medical Office Specialist Certificate - Medical Office
South Texas Vocational Technical Institute - McAllen
Mcallen, TX04.2000
Skills
- 10-Key Certification
- Complex Problem-Solving
- Client Information Databases
- Database Data Entry
- Spreadsheet Management
- Data Verification
- Document Management and Storage
- Excel Formulas
- Data Transcription
- Monthly Closings
- Customer Satisfaction
- Special Projects
Timeline
Data Processing
Starr County Memorial Hospital
07.2012 - Current
Medical Insurance Biller
Starr County Memorial Hospital
04.2000 - 03.2008
Excel Intermediate ITSW 2029.M01 - General Office Services
South Texas College
Medical Office Specialist Certificate - Medical Office
South Texas Vocational Technical Institute - McAllen
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