Juliet Luna
Chicago,IL
Summary
Results driven Medical Biller with over 20 plus years of hands-on experience in account management, revenue generation and medical billing and coding. Accomplished in developing strategies to improve workflows and processes and actualizing procedures to enhance revenue generation. Demonstrated leadership skills, guide teams towards success, optimize performance and sustain organizational success. Committed and results-oriented, willing to go above and beyond to contribute to team objectives.
Overview
30
30
years of professional experience
Work History
Billing Representative
Northshore University HealthSystems /Endeavor
Skokie, IL
03.2009 - 02.2024
- Ability to constantly evaluate and prioritize workload.
- Ability to quickly problem solve and identify appropriate issues to management.
- Working knowledge of billing requirements for Medicare.
- Abides by all of the applicable policies ,procedures and guidelines of NorthShore University HealthSystem.
- Knowledge and application of policies and procedures that apply to job and area of responsibility.
- Analyze, investigate, prioritize and resolve daily prioritized daily work queue error per department policy.
- Exceeds or meets daily productivity and quality standards.
- Review all available resources to locate missing or correct information to allow billing.
- Clearly,concisely and accurately document account with actions taken and status per department policy.
- Apply creative problem solving skills in order to overcome obstacles and to resolve errors.
- Correct errors in system until edit criteria has been satisfied
- Use fact finding and documentation to identify common issues.
- Be positive with other team members in attitude and behavior and assists whenever possible.
- Perform every step when working the account to obtain immediate resolution.
- Perform other duties as assigned by team Lead or Manager.
Billing Supervisor
Rush Northshore Medical Center
Skokie, IL
10.2002 - 03.2009
- Assumes responsibility for supervising activities related to the processing of inpatient and outpatient charges to various payers
- Provides overall supervision for Billing staff.
- Assists in training, educating and evaluating staff to ensure efficient billing process.
- Works as an Ecare Specialist/Coordinator making sure that the system run smoothly and efficiently for the department and communicates to Systems Analyst,information systems and Nebo any problems or issues that may arise.
- Works with Revenue Cycle team to ensure smooth,efficient and cost effective processes and develop action plan for the department.
- Monitors written procedures and communicates changes effectively to staff.
- Communicates aging,cash and productivity reports through individual and monthly staff meetings.
- Monitors productivity by utilizing weekly backlog report.
- Maintains electronic billing system to ensure smooth billing process.
- Implements and maintains internal controls for Billing Department with the Manager and Director of Patient Financial Services Unit.
- Ensures all claims are processed in accordance with governmental and third party regulations.
- Identifies to Finance, additions and updates to HCPC codes that needs to be entered to the CDM profile.
- Helps other departments with charge related issues like late charges or corrections.
- Helps with the Information System with the manual entry of revised coding as to diagnosis and procedure codes that did not interface in Invision System at the back end.
- Perform other duties that may be assigned by the Manager and Director of PFS.
Biller
Rush North Shore Medical Center
Skokie, IL
10.2000 - 10.2002
- Reviews Medicare OCE/CCI edits to ensure appropriate billing on a daily basis.
- Makes corrections to bills,if necessary and communicates rejections to appropriate departments.
- Process monthly IME bills to Medicare utilizing the SMS adhoc report "Inpatient HMO over 65 years". Follow up on IME claims through FSSO.
- Adds through SMS Invision system accommodation charges for Palliative Care Center bills and request rebills. Enter RUG's data into Invision system for TCU billing and request rebills for appropriate claim submission.
- Completes daily workload of bills including daily documentation.
- Review ABN claims for LMRP's and bills Medicare for denial .
- Forwards ABN's with denial from Medicare collectors for demand bill.
- Performs other duties that may be assigned by he Supervisor or Manager.
Billing Clerk
Lifescan Laboatory
Skokie, IL
04.1998 - 05.2000
- Performed filing duties including sorting incoming mail, maintaining filing system, and organizing documents.
- Billing, downloading, bar coding of patient laboratory tests, answering multi-line phones,handling customer queries and complaints.
- Data entry for Microsoft Office suit and custom software programs, trouble shooting minor computer problems.
- Providing assistance to other departments and performing other general office duties.
Data Entry Clerk
Northern Illinois Laboratory, LTD
Chicago, IL
01.1995 - 12.1996
- Performed data entry from paper documents, emails, and other sources into computer systems.
- Verified accuracy and completeness of data entry into the database system.
- Operated various office equipment such as scanners, printers. when required.
- Maintained confidentiality of sensitive information entered into the system.
- Checked source documents against entered data to ensure accuracy.
- Assisted colleagues with resolving any issues related to data entry operations.
- Data encoding,checking requisitions to ensure proper information na test codes.
- Answering phone calls,calling alert results to Nursing Homes.
- Performing other tasks that may be assigned from time to time.
Regional Wholesale Processor
Mellon Financial Services
Chicago, IL
01.1994 - 12.1995
- Ensured compliance with all applicable regulations, laws, and guidelines.
- Filed paperwork according to standard operating procedures and entered data points into tracking system.
- Processed documents to maintain records and files.
- Reviewed order forms to prepare orders for processing.
- Preserved safe and clean work environment by keeping shelves, pallet area and workstations neat.
- Ensured proper security measures were taken when handling sensitive customer data.
- Manual processing of payments from different institutions.
- Sorting and packing mails handled according to vendor specifications.
Education
Bachelor of Science - Commerce Major in Business Administration
University of Santo Tomas
Philippines10-1984
Skills
- Account Reviews
- Insurance Claims
- Account Management
- Data Entry Experience
- Customer Relations Skills
- Account Monitoring
Timeline
Billing Representative
Northshore University HealthSystems /Endeavor
03.2009 - 02.2024
Billing Supervisor
Rush Northshore Medical Center
10.2002 - 03.2009
Biller
Rush North Shore Medical Center
10.2000 - 10.2002
Billing Clerk
Lifescan Laboatory
04.1998 - 05.2000
Data Entry Clerk
Northern Illinois Laboratory, LTD
01.1995 - 12.1996
Regional Wholesale Processor
Mellon Financial Services
01.1994 - 12.1995
Bachelor of Science - Commerce Major in Business Administration
University of Santo Tomas
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