Karla Garcia-Soto
Henderson,NV
Summary
Accomplished Orthodontic Medical Biller/Manager with a proven track record at Seven Hills Orthodontics, adept in insurance claims and bilingual communication. Excelled in enhancing financial performance through meticulous audits and resolving payment disputes, while mentoring staff and ensuring patient satisfaction. Skilled in Microsoft Office and customer service management, consistently achieving successful reimbursements and fostering positive relations.
Overview
11
11
years of professional experience
Work History
Orthodontic Medical Biller
Hansen Orthodontics
10.2021 - 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.
- Posted payments and collections on regular basis.
- Supported efficient scheduling practices by verifying patient eligibility and coverage prior to appointments.
Orthodontic Medical Biller /Medical Coder Manager
Seven Hills Orthodontics
01.2018 - 09.2021
- Developed and orally presented to Senior Management weekly financial reports.
- 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.
- Collaborated with customers to develop payment plans and bring accounts current.
- Provided translation (English/Spanish) for physicians and patients.
- Trained and mentored staff on procedures, complaint requirements, and collection techniques.
- Conducted regular audits of billing records to ensure accuracy and completeness, enhancing overall financial performance for the practice.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Negotiated with insurance providers to resolve payment disputes, ensuring fair compensation for services rendered.
- Implemented comprehensive audit system for billing procedures, identifying and rectifying process gaps.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Reviewed Account receivables with Doctors and Senior Management.
Trade Show Technician
World Market Center of Las Vegas
03.2014 - 07.2017
- Overall cleaning and Maintenance of all showrooms.
- Managed inventory of equipment, maintaining adequate stock levels for uninterrupted productions.
- Completed partial or full dismantling of equipment to quickly repair or replace defective components and restore functionality.
Manager on Duty
Baja Fresh
03.2014 - 07.2017
- Trained employees in essential job functions.
- Responded to customer concerns by providing friendly, knowledgeable support, and maintaining composure and professionalism.
- Handled employee-related issues to improve performance, professional conduct, and attendance reliability.
- Provided exceptional customer service, addressing concerns promptly and ensuring repeat business from satisfied clients.
- Supervise and Coordinate all culinary activities.
- Managed labor and scheduling.
- De-escalate customers with dispute
- Adhere to all safety and sanitation regulations.
Education
Medical Coding And Billing Associates Degree
Asher College
Las Vegas, NV01-2025
High School Diploma -
Clark County Adult Ed
Las Vegas, NV06-2015
Skills
- Problem Solving
- Treatment Documentation
- Code error resolution
- Microsoft Office
- Multitasking and prioritization
- Verbal and written communication
- Customer/patient deescalating and service Management
- Problem solving
- Insurance Claims
- Bilingual
Languages
Spanish
Native or Bilingual
Timeline
Orthodontic Medical Biller
Hansen Orthodontics
10.2021 - Current
Orthodontic Medical Biller /Medical Coder Manager
Seven Hills Orthodontics
01.2018 - 09.2021
Trade Show Technician
World Market Center of Las Vegas
03.2014 - 07.2017
Manager on Duty
Baja Fresh
03.2014 - 07.2017
Medical Coding And Billing Associates Degree
Asher College
High School Diploma -
Clark County Adult Ed
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