Juanita Rubalcava
Hinesville,GA
Summary
Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information. Driven Medical Biller motivated to perform beyond expectations.
Overview
15
15
years of professional experience
Work History
Medical Biller
Fraser Counseling Center
09.2020 - Current
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Filed and updated patient information and medical records.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Collected payments and applied to patient accounts.
- Posted payments and collections on regular basis.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Liaised between patients, insurance companies, and billing office.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Delivered timely and accurate charge submissions.
- Collaborated with healthcare providers, ensuring accurate documentation for seamless billing operations.
- Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
- Adhered to established standards to safeguard patients' health information.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Assisted patients in understanding insurance benefits, leading to a positive experience during their visit.
- Reduced instances of denied claims, carefully reviewing and rectifying coding errors before submission.
- Responded to customer concerns and questions on daily basis.
- Processed vendor and supplier payments on weekly basis.
- Generated monthly billing and posting reports for management review.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Maintained accurate records of customer payments.
- Collaborated with customers to resolve disputes.
- Utilized various software programs to process customer payments.
- Reconciled accounts receivable to general ledger.
Office Manager
Eric L Hall
09.2009 - 08.2019
- Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
- Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
- Maintained accurate financial records by reconciling accounts payable/receivable transactions regularly to ensure balanced budgets.
- Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
- Enhanced team productivity by delegating tasks effectively and overseeing daily workflow.
- Coordinated office events and meetings, ensuring timely execution and optimal scheduling for all participants.
- Served as a liaison between upper management and staff members, facilitating open channels of communication to address concerns or issues promptly.
- Managed vendor relationships, negotiating contracts for cost savings while maintaining high-quality services.
- Developed comprehensive policy manuals outlining procedures and guidelines, contributing to a well-organized workplace culture.
- Reduced costs with meticulous budget monitoring and expense tracking for essential supplies and equipment.
- Handled sensitive employee and client information with utmost confidentiality, maintaining trust and integrity.
- Oversaw office budget, ensuring all expenditures were within allocated funds and identifying cost-saving opportunities.
- Streamlined document handling and processing, reducing turnaround time for client inquiries and requests.
- Coordinated with IT department to upgrade office technology, enhancing overall efficiency and data security.
- Assisted in organizing and overseeing assignments to drive operational excellence.
- Successfully managed budgets and allocated resources to maximize productivity and profitability.
- Opened and closed location and monitored shift changes to uphold successful operations strategies and maximize business success.
- Improved staffing during busy periods by creating employee schedules and monitoring call-outs.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
- Trained personnel in equipment maintenance and enforced participation in exercises focused on developing key skills.
- Assessed processes and procedures, complying with OSHA, and HIPAA regulations.
- Managed daily administrative tasks to ensure smooth operations within the medical office environment.
- Called insurance companies to get precertification and other benefits information on behalf of patients.
- Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
- Streamlined referral processes for increased efficiency, resulting in timely appointments for patients.
- Developed strong relationships with external healthcare facilities, fostering a collaborative approach to patient care coordination.
- Scheduled appointments with specialists on behalf of clients.
- Managed high-volume referral requests by prioritizing tasks and maintaining organized records.
- Acted as a liaison between referring physicians and specialists, establishing trust and rapport through professionalism.
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Improved communication between medical staff and patients by explaining insurance benefits and financial responsibilities.
- Updated patient records with accurate, current insurance policy information.
- Increased patient satisfaction by promptly addressing concerns regarding insurance coverage or billing issues.
- Enhanced claim processing efficiency by verifying insurance coverage and obtaining pre-authorizations for procedures.
Education
Associate of Applied Science - Medical Assisting
University of Alaska Fairbanks
Fairbanks, AK05.2003
Skills
- Insurance Claims
- Medical Billing
- Insurance Billing
- Electronic Claims
- HIPAA Compliance
- Insurance Verification
- Billing and Collection Procedures
- Patient Billing
- CPT Knowledge
- Customer Service
- Accounts Receivable
- Insurance claims processing
- Medicaid and Medicare Knowledge
- CMS-1500 Billing Forms
- Data Entry
- Electronic Health Record Software
- ICD-10 Proficiency
- Medical coding knowledge
- Records Management
- Multitasking and Organization
Content
The career service live was great to watch and learn some new things to help when it comes to resume building and job searching. LinkedIn is a resource that I currently use but I don’t use on a regular basis when it comes to my job search. I feel I need to utilize this resource to showcase my career skills and educational experience much better. I want to attend a resume building course. I always feel my resume is weak and doesn’t showcase my skills and experience as much as it should. I also want to attend a career resource seminar. I didn’t realize that DeVry had so many ways to help students jump start or change careers and help with the advancements they need. The attendance code is CARD2024LS
Timeline
Medical Biller
Fraser Counseling Center
09.2020 - Current
Office Manager
Eric L Hall
09.2009 - 08.2019
Associate of Applied Science - Medical Assisting
University of Alaska Fairbanks