Karina Diaz
Mission Hills,CA
Summary
To obtain a position with a well-established organization that offers professional growth. Talented Team Leader experienced and dedicated to enhancing employee satisfaction and business success. Diplomatic and friendly with proven commitment to employee training. Hardworking team player bringing necessary experience and knowledge to tackle any operational demand.
Overview
16
16
years of professional experience
Work History
Team Lead
Medtronic
07.2016 - Current
- Supervise a team of 20 insurance verification and collections specialists, providing training, mentorship, and performance evaluations.
- Lead team meetings to discuss process improvements, performance metrics, and address any issues or challenges
- Analyze revenue cycle data and reporting to identify trends, areas for improvement, and to develop strategies to optimize financial data.
- Managed schedules, accepted time off requests and found coverage for short shifts.
Collections
Medtronic
06.2014 - 06.2016
- Managed collections for commercial, Medicaid and Medicare insurance claims, ensuring timely and accurate processing of claims and reimbursements.
- Review payer Explanation of Benefits (EOB), and other payer correspondence, calculating patient responsibility taking into consideration coverage and benefits, including referrals, authorizations, and/or pre-determination requirements and contract terms.
- Ensured compliance with all relevant regulations and internal policies when handling collection claims for commercial, Medicaid, and Medicare accounts.
- Exceeded team metrics of 30 accounts per day in addition to assisting with high incoming call volume and email escalation assist,
Medical Biller
Targeted Medical Parma
08.2011 - 06.2014
- Workers' Compensation and Private Insurance billing
- Resubmission of unpaid claims
- Reconciliation of physician's reports
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Verified accuracy of accounts payable payments, resulting in 10% reduction in payment errors and check reissues.
Medical Billing and Collections
Medtronic
12.2009 - 08.2011
- Reviewing and Billing insurance companies
- Validating eligibility requirements and ensuring accurate account information is received to guarantee maximum reimbursement in timely manner.
- Increased accuracy of medical billing by meticulously verifying proper coding for diagnoses and procedures in patient charts.
Medical Billing and Collections
Global Healthcare Alliance
11.2008 - 10.2009
- Worked closely with Physicians/Patients to obtain accurate insurance information for prompt payments
- Maintaining aging accounts and prevent aging AR and DSO
- Answering questions from patients or Physician offices concerning EOB
Education
Bachelor of Science - Business
University of Phoenix
Tempe, AZ03.2024
Medical Billing Insurance Coding - Healthcare Billing
UEI College
Van Nuys, CA08.2010
Skills
- Customer Focus
- Coaching and Mentoring
- Performance monitoring
- Performance Improvement
- Medical Billing
- Electronic Claims
- Billing and Collection Procedures
- Accounts Receivable
- Electronic Health Record Software
- Claims review
- Knowledgeable in Athena IDX
- ICD-10 Proficiency
- HIPAA Regulations
- HCPCS Coding
- Denial Management
- Healthcare compliance
Employment Skills
- 10+ years revenue cycle experience
- 7+ years healthcare billing/collections
- Ability to work in a fast-paced environment
- Maintained excellent customer relations
- Goal-oriented with strong leadership capabilities
- Ability to follow instructions and make decisions with no supervision
- Proficient with Excel, Microsoft Powerpoint
- Organized and detail-directed problem solver
- Proficient in all documentation, record maintenance to ensure accuracy and patient confidentiality
- Team Player
- Self-Motivated
Languages
Spanish
Native or Bilingual
Timeline
Team Lead
Medtronic
07.2016 - Current
Collections
Medtronic
06.2014 - 06.2016
Medical Biller
Targeted Medical Parma
08.2011 - 06.2014
Medical Billing and Collections
Medtronic
12.2009 - 08.2011
Medical Billing and Collections
Global Healthcare Alliance
11.2008 - 10.2009
Bachelor of Science - Business
University of Phoenix
Medical Billing Insurance Coding - Healthcare Billing
UEI College
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