Larissa Salas
Houston
Summary
Medical billing professional with strong focus on accuracy and efficiency in processing healthcare claims. Demonstrates thorough understanding of insurance guidelines and billing procedures. A reliable team player who adapts to changing needs and is committed to achieving optimal results through collaboration and attention to detail.
Overview
8
8
years of professional experience
Work History
Medial Biller
Radiation Business Solutions
03.2024 - Current
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Filed and updated patient information and medical records.
- Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
Eligibility Representative
Elevance Health
09.2022 - Current
- Applies specialized experience in group health insurance administration, particularly carrier enrollment, to maintain accurate client records and streamline operations.
- Performs meticulous reconciliation of monthly carrier invoices against client records, ensuring absolute accuracy and prompt resolution of discrepancies, enhancing financial integrity.
- Excels in customer service, promptly and effectively addressing client queries and concerns, securing a high customer satisfaction rate.
- Utilizes comprehensive knowledge of COBRA, HIPAA, EDI files, Qualifying Life Events (QLE), and Protected Health Information (PHI) to manage and resolve complicated eligibility issues, reducing resolution times significantly.
Medical Billing/Claims Specialist
Universal Select Group
01.2021 - 06.2021
- Diligently reviewed and analyzed insurance claims, ensuring their validity, completeness, accuracy, and eligibility for payment.
- Conducted thorough research on medical records to validate claims and verify any pre-existing conditions.
- Executed periodic audits on closed files to confirm the accuracy of documentation and adherence to regulations.
Claims/Warranty Administrator
Texan Hyundai
09.2017 - 09.2019
- Orchestrated the management and substitution of defective customer products, guaranteeing swift resolution or repair.
- Scrutinized and streamlined warranty claims, reaffirming the accuracy of all pertinent information.
- Fostered and sustained relationships with vendors and third-party providers, enhancing warranty service operations.
Education
High School Diploma -
Hightower High School
Missouri City, TX01.2006
Skills
- Group Health Insurance Administration
- Proficiency in Microsoft Excel
- Ability to Multitask and Prioritize Workload
- Commitment to Confidentiality and Data Protection
- Data Entry
- Problem Solving
- Conflict Resolution
- Healthcare Operations
- Time Management
- Compliance (HIPAA)
- Medical and Claim Terminology
- Data Collection and Documentation
- Strong Knowledge of Medical Coding and Billing Processes (CPT, ICD-10, HCPCS)
- Familiarity With Insurance Regulations and Industry Standards
- Excellent Analytical and Problem-Solving Skills
- Exceptional Attention to Detail and Accuracy
- Ability to Prioritize Tasks and Meet Deadlines in a Remote Work Environment
- Insurance billing
- CPT knowledge
- CMS-1500 billing forms
- Electronic health record software
Timeline
Medial Biller
Radiation Business Solutions
03.2024 - Current
Eligibility Representative
Elevance Health
09.2022 - Current
Medical Billing/Claims Specialist
Universal Select Group
01.2021 - 06.2021
Claims/Warranty Administrator
Texan Hyundai
09.2017 - 09.2019
High School Diploma -
Hightower High School
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