Leslie "Joy" Venegas
McDonough,GA
Summary
Dependable, well-organized and logical, with expertise in a office based surgical practice setting. Talented at medical documentation data verification. Quality-driven by checking codes for correctness. Seeking out opportunities to go beyond basics, improve processes, and increase customer satisfaction.
Overview
37
37
years of professional experience
Work History
Billing and Prior Authorization Specialists
Peachtree Vascular Specialists PC
Stockbridge, GA
07.1999 - Current
- Verified patient insurance coverage, including eligibility, benefits, and authorization requirements for medical services.
- Initiated and obtained prior authorizations by extracting data from the medical record to meet medical necessity criteria for a surgical practice.
- Entered procedure codes, diagnosis codes, and patient information with precision into billing software to ensure generation of accurate claims.
- Ensured high success rate of claims by researching and resolving rejections and denials.
- Collected and posted insurance payments, along with managing patient account payments efficiently.
- Expedited resolution of denials, rejections, and information requests for prompt handling.
- Drafted accurate and grammatically correct medical necessity and coding appeals, while seeking clarification for ambiguous coding.
- Maintained accurate records of payment history and financial data, thereby keeping customer accounts up-to-date in the system.
- Ensured accurate and timely delivery of month-end statements to customers, addressing any queries or issues promptly.
- Delivered exceptional customer service by addressing patient calls promptly, scheduling appointments, and providing comprehensive guidance on insurance claims and patient financial obligations.
- Reviewed and assessed accounts for potential transfer to outside collections.
Medical Office Administrator OB/GYN
Glisson, Dees, Albee, Carroll & Echemendia
Dunwoody, GA
06.1987 - 06.1999
- Provided exceptional patient experience through friendly and compassionate communications.
- Registered patients and scheduled appointments.
- Collected information, verified insurance and collected co-payments for patients as part of check-in process.
- Conducted insurance verification and pre-authorization.
- Gathered information to minimized inaccuracies by maintaining accurate records.
- Submitted diagnosis and procedure codes for insurance companies.
- Communicated with patients regarding payments on outstanding accounts.
Education
Medical Billing And Coding
Dekalb Technical College
Clarkston, GA09.1994
High School Diploma -
Forest Park High School
Forest Park, GA06.1983
Skills
- Accounts Receivable Expertise
- Work Planning and Prioritization
- Effective communication skills
- Problem-solving abilities
- Analytical Skills
Timeline
Billing and Prior Authorization Specialists
Peachtree Vascular Specialists PC
07.1999 - Current
Medical Office Administrator OB/GYN
Glisson, Dees, Albee, Carroll & Echemendia
06.1987 - 06.1999
Medical Billing And Coding
Dekalb Technical College
High School Diploma -
Forest Park High School
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