Leticia Munoz
Yuba City,CA
Summary
Competent Medical Biller Follow Up Associate with 20 years of experience in handling wide variety of medical coding and billing tasks. Sophisticated and hardworking individual with excellent analytical and multitasking abilities. Coordinates with insurance companies and expedites claims processes. Expertise in accurately inputting procedure and diagnosis codes into billing software to generate invoices.
Overview
28
28
years of professional experience
Work History
Patient Access Representative
Adventist Health
02.2012 - Current
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Adapted quickly to changing demands within the healthcare environment, demonstrating flexibility and a strong commitment to quality patient care.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Provided excellent customer service through active listening skills, understanding patient needs, and offering tailored solutions where applicable.
- Contributed to a positive work environment by fostering strong relationships among colleagues, promoting teamwork, and sharing best practices.
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
- Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
- Enhanced overall patient experience with empathetic communication and thorough explanations of insurance benefits and coverage.
- Facilitated smooth billing processes by verifying insurance eligibility, obtaining authorizations, and accurately entering claim details into the system.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Developed proficiency in various healthcare software programs for accurate documentation of patient encounters and streamlined workflows within the department.
- Supported medical staff by coordinating diagnostic testing appointments, lab results retrieval, and necessary referrals in a timely manner.
- Resolved patient billing issues in line with established guidelines.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Reduced financial loss through diligent monitoring of outstanding balances and proactive collection efforts with patients and insurers.
- Assisted with administrative tasks such as filing, data entry, and report generation to support streamlined office operations.
Billing Assistant
Rideout Hospital
02.2012 - 02.2017
- Enhanced customer satisfaction by promptly addressing and resolving billing inquiries or disputes.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Improved billing accuracy by diligently reviewing and verifying invoice data before submission.
- Received, sorted, and distributed incoming mail.
- Reduced errors in billing documentation by implementing a thorough double-check system.
- Managed electronic filing system for efficient organization of billing documents, resulting in improved accessibility for internal teams.
- Minimized errors in claim submissions through thorough pre-audit reviews, ensuring compliance with established protocols.
- Safeguarded patient privacy, adhering to strict HIPAA regulations during all aspects of the billing process.
- Maintained professional demeanor while communicating with patients or insurance companies to resolve payment issues, fostering positive relationships.
- Collaborated with healthcare providers to obtain necessary documentation for accurate claim submissions.
- Strengthened client relationships through clear communication and prompt resolution of billing concerns.
- Increased team efficiency by providing cross-functional support in medical coding, insurance verification, and data entry tasks.
- Optimized workflow efficiency within the department using strong organizational skills when prioritizing tasks under tight deadlines.
- Maximized reimbursement opportunities by staying current on industry trends and new billing procedures.
- Liaised between patients, insurance companies, and billing office.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
Medical Billing Manager
Douglas G. Tolley MD
10.1996 - 01.2012
- Reviewed billing problems, researched issues, and resolved concerns.
- Worked with customers to develop payment plans and bring accounts current.
- Increased patient satisfaction by addressing billing inquiries promptly and professionally.
- Developed strong relationships with insurance companies through effective communication and negotiation skills, enhancing payment turnaround times.
- Reduced denied claims through diligent review, correction, and resubmission of errors.
- Developed policies and procedures for the medical billing department, establishing a strong foundation that supported growth and operational success within the organization.
- Analyzed reports to identify areas for improvement in the overall billing process, leading to increased revenue collection rates.
- Served as an expert resource on complex patient account issues or high-dollar claims requiring specialized handling, ultimately resolving outstanding balances in an efficient manner.
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
- Established and checked coding procedures, monitored reports and updated internal files.
- Established internal audit procedures to validate and improve accuracy of financial reporting.
- Developed strategic plans for day-to-day financial operations.
- Prepared internal and regulatory financial reports, balance sheets and income statements.
- Assisted in budget planning, forecasting revenues based on historical trends, payer mix analysis, and other relevant factors affecting financial performance indicators.
- Evaluated vendor contracts for external services such as collections agencies or clearinghouses, negotiating favorable terms that improved bottom-line results.
- Checked payroll, vendor payments, commissions and other accounting disbursements for accuracy and compliance.
- Improved overall financial reporting by streamlining control processes and reporting structures.
- Conducted financial due diligence on potential investments and acquisitions.
- Trained and mentored staff on procedures, compliance requirements, and collections techniques.
- Conducted performance reviews and implemented improvement plans.
Education
High School Diploma -
Marysville High School
Marysville, CA06.1988
Skills
- Customer Service
- Insurance Verification
- HIPAA Compliance
- ICD-10 Proficiency
- CPT Knowledge
- Claim submission
- Denial Management
- Patient Billing
- Medical Coding Expertise
- Payment posting
- Teamwork
- Teamwork and Collaboration
Languages
Spanish
Full Professional
Timeline
Patient Access Representative
Adventist Health
02.2012 - Current
Billing Assistant
Rideout Hospital
02.2012 - 02.2017
Medical Billing Manager
Douglas G. Tolley MD
10.1996 - 01.2012
High School Diploma -
Marysville High School