Liceth Zavala
Salinas,CA
Summary
Experienced with medical billing procedures and coding standards. Utilizes strong analytical skills to ensure accurate claim submissions and resolution. Knowledge of insurance guidelines and healthcare regulations, consistently delivering precise billing operations.
Overview
15
15
years of professional experience
Work History
Medical Billing Specialist
Jeffrey D. Carter M.D.
09.2010 - Current
- Assisted in processing medical claims for timely reimbursement.
- Learned to navigate billing software and maintain accurate patient records.
- Supported resolution of discrepancies in billing and insurance claims.
- Collaborated with healthcare providers to gather necessary documentation.
- Maintained knowledge of coding regulations and compliance standards.
- Engaged in ongoing training to enhance understanding of medical billing processes.
- Contributed to data entry tasks, ensuring accuracy and attention to detail.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Located errors and promptly refiled rejected claims.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Identified and resolved patient billing and payment issues.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
- Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
- Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
- Collected payments and applied to patient accounts.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Precisely evaluated and verified benefits and eligibility.
- Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.
- Filed and updated patient information and medical records.
- Liaised between patients, insurance companies, and billing office.
- Printed and reviewed monthly patient aging report and solicited overdue payments.
- Conducted regular audits of patient accounts for potential underpayments or overpayments due to incorrect coding or billing practices.
- Reduced errors in medical billing by meticulously reviewing patient records and ensuring accurate coding.
- Prepared billing correspondence and maintained database to organize billing information.
- Contributed to overall office organization by maintaining up-to-date records of all billed services and payments received.
- Evaluated patients' financial status and established appropriate payment plans.
- Collaborated closely with the clinical team to ensure proper documentation was obtained for accurate billing purposes.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Delivered timely and accurate charge submissions.
- Collaborated with customers to resolve disputes.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Handled account payments and provided information regarding outstanding balances.
- Generated monthly billing and posting reports for management review.
- Monitored outstanding invoices and performed collections duties.
- Reconciled accounts receivable to general ledger.
- Verified insurance of patients to determine eligibility.
- Maintained accurate records of customer payments.
- Audited and corrected billing and posting documents for accuracy.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
Education
High School Diploma -
North Monterey County High School
Castroville06-1999
Skills
- Medicare and medicaid process
- Quality-oriented team player
- Customer service
- CMS-1500 billing forms
- Electronic health record software
- Multitasking and organization
- Knowledgeable in Isalus
- Collection calls
- Payer contracts
- Workers Compensation billing
Languages
Spanish
Native or Bilingual
Timeline
Medical Billing Specialist
Jeffrey D. Carter M.D.
09.2010 - Current
High School Diploma -
North Monterey County High School