Leticia Robledo
Houston,TX
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
16
16
years of professional experience
Work History
Medical Billing Manager
Avante Ambulance Inc
Houston, Texas
12.2023 - 02.2024
- Reviewed appeals processes and assisted in preparing appeal letters when necessary.
- Maintained detailed records of all payments received from patients or third-party payers.
- Managed and reviewed medical billing staff to ensure accuracy of patient accounts.
- Resolved issues related to denied or rejected payments from insurance companies.
- Worked closely with clinical staff to ensure timely submission of claims and accurate coding practices.
- Monitored accounts receivable aging reports and worked proactively to reduce outstanding balances due from patients or insurers.
- Resolved billing issues by applying knowledge and completing in-depth research.
Senior Medical Biller
Pediatric Transport EMS
Houston, Texas
11.2014 - 11.2023
- Reviewed and corrected medical billing documents for accuracy prior to submission.
- Analyzed patient records, insurance information, and medical coding data to ensure proper reimbursement from insurance companies.
- Identified areas of improvement within current workflows in order to increase revenue cycle efficiency.
- Provided technical assistance to office personnel regarding billing inquiries or problems encountered during daily operations.
- Researched rejected claims due to incorrect coding or inaccurate information submitted by providers.
- Processed electronic payments from payers in a timely manner according to established deadlines.
- Submitted appeals to insurance carriers on denied claims.
- Maintained accurate documentation of all activities related to medical billing functions.
- Evaluated patient bills for completeness and accuracy prior to submission for payment processing.
- Monitored changes in healthcare regulations that could affect the organization's revenue cycle processes.
- Performed eligibility checks on patients' insurance coverage prior to services being rendered.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Completed and submitted appeals for denied claims.
- Submitted appeals using provider portals and phone communication.
Medical Claims Specialist
GMA Medical Billing
Houston, Texas
09.2007 - 10.2014
- Processed appeals on rejected or partially paid claims, including filing additional paperwork as needed.
- Reviewed denials, rejections, and underpayments from insurance carriers.
- Verified patient eligibility for medical claims and determined benefit coverage.
- Submitted and tracked medical claims to insurance companies via electronic or paper methods.
- Responded promptly to customer inquiries regarding claim status updates.
- Sent clinical request and missing information letters to obtain incomplete information.
- Documented file notes clearly and concisely in Medisoft.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Handled billing related activities focused on medical specialties.
Education
Medical Billing And Coding Certificate - Medical Billing And Coding
National Institute of Technology
Houston, TX05-2005
High School Diploma -
Brazoswood High School
Clute05-1992
Skills
- Revenue Cycle Management
- Claims Processing
- Collections Management
- Workflow Planning
- HIPAA Knowledge
- Payment Posting
- Insurance Verification
Timeline
Medical Billing Manager
Avante Ambulance Inc
12.2023 - 02.2024
Senior Medical Biller
Pediatric Transport EMS
11.2014 - 11.2023
Medical Claims Specialist
GMA Medical Billing
09.2007 - 10.2014
Medical Billing And Coding Certificate - Medical Billing And Coding
National Institute of Technology
High School Diploma -
Brazoswood High School