Lillian Rodriguez
Anaheim,CA
Summary
Highly capable and detail oriented professional seeking a position as a Administrative Assistant in a growth-orientated company where I can leverage my administrative and organization skills to support staff, possessing uncompromising work ethic. Stellar customer service.
Overview
13
13
years of professional experience
Work History
Billing Specialist III
MediRevv
Anaheim, CA
06.2020 - Current
- Responsible for all aspects related to insurance claims to maximize revenue streams.
- Provided tenacious follow-up to ensure proper payments were fully collected.
- Followed up on timely filing on all claims as needed under strict deadlines
- Responsible for analyzing claims and filling secondary claims as needed
- Audited all commercial and Medi - Medi claims
- Verified insurance Eligibility, contact with both patient and payors
- Research and resolve incorrect payments, EOB rejections and other issues with outstanding balances.
- Proficiency in Muli-tasking when managing administrative work and ensuring top level patient care and support.
Implementation Consultant
AdvancedMD
South Jordan, UT
06.2019 - 05.2020
- Implemented clients on AdvancedMD billing software, trained all new clients (physicians, nurses, front/back end staff, billers, administration staff) via Go To Meeting
- All trainings where broken up into milestones dependent on the role of the staff that was being trained, all trainings were tailored to the need of the specialty of each practice
- Some clients were well versed in practice for many years as well as clients opening up private practices
- Helped clients with questions and or concerns with HIPPA, EDI Agreements, Insurance Carriers, Clearing House, Collecting Monies ( copays, patient responsibilities) running reports for end of day, collections.
Insurance Billing Coordinator
Bristol Home Care and Hospice
Salt Lake City, UT
10.2018 - 06.2019
- Billed all claims for Home Care and Hospice, Respite Care for 32 locations assigned, payor's such as Medi-cal and Medicare, VA, Commercial Insurance, responsible for running eligibility for all patients uploading claims to clearing house and creating invoices to each home care and Hospice Facilities, challenging denials with a 95% success rate.
Billing Manager
Highland Springs Specialty Clinics, Valley Behavioral Health
Millcreek, UT
02.2015 - 11.2018
- Responsible in overseeing the Billing Department for 5 Specialty clinics with the only payer accepted was commercial insurance, supervise and assure Billing coordinators were adequately trained to bill and challenge denied claims
- Improved revenue for all clinics, Extensive audits and provide patients with a better understanding of PR's, post and reconcile insurance and patient payments , Research and resolve incorrect payments, EOB rejections Denials resolve other issues with outstanding accounts
- Submission of secondary payor claims upon processing of primary insurance
- Follow up on insurance and patient aging
- Re-Submit insurance claims as necessary
- Knowledgeable in timely filing restrictions
- Properly handle escalated supervise calls
- Responsible for creating Standard Operating Procedures
- Responsible for interviews and hiring for department.
Patient Service Representative / Insurance Verification Representative
Intermountain Homecare & Hospice
South Jordan, UT
03.2013 - 03.2015
SpecialtyImplementation
- Responsible to register all patients, obtain all current information, input insurance information, advise and educate patient on forms to be signed, Inform patients of Financial Assistance for those patients without insurance, collect copay's, scan all patient information into Help 2, Assist in having patients triaged for Red Flag's, Assist physicians/Nurses in translating when interpreter unavailable, coordinate Interpreters for visits, schedule appointments, reserve call ahead's, maintain cash on hand, batch out process at end of each shift
- Monitor incoming Prescriptions for Medical Equipment, Transcribe Prescriptions, Request all necessary test and exams required to obtain authorization.
Hedis Data Coordinator
Aetna / Schaller Anderson Inc
Orange, CA
03.2011 - 03.2013
- Patient's inquiries, complaints, billing questions
- Monitored staff to ensure good customer service delivery
- Delegated tasks to customer service staff
- Answered customer questions and resolved issues
- Communicated with customers, staff and upper management
- Completed all paperwork as required
- Reported issues to senior management
- Responsible to audit all data for Childhood and Adolescent Immunization Status (HEDIS Program)
- Participated in training and development programs.
Education
Associate of Arts - General Studies Education, Business Administration
Cerritos College
01.2003
Skills
- Responsible for Writing of Dept SOP's
- Online Claim Submission
- Management / Supervisory Skills
- Claim Entry & Payment Posting
- Multiple Phone Line
- Microsoft Office Suites
- Stellar Customer Service
- Collections Accounts Payable/Receivable
- HIPPA Compliance
- Medical Insurance Insurance Verification
- Accounts Payable, Accounts Receivable
- Organizational skills
- Benefits
- Billing, Invoices
- Call Center
- Customer Service, Problem resolution
- Bilingual - Spanish
- Faxing, Filing, Data Entry
- Supervisory Skills
- Translating
- Hiring
- Meetings
Timeline
Billing Specialist III
MediRevv
06.2020 - Current
Implementation Consultant
AdvancedMD
06.2019 - 05.2020
Insurance Billing Coordinator
Bristol Home Care and Hospice
10.2018 - 06.2019
Billing Manager
Highland Springs Specialty Clinics, Valley Behavioral Health
02.2015 - 11.2018
Patient Service Representative / Insurance Verification Representative
Intermountain Homecare & Hospice
03.2013 - 03.2015
Hedis Data Coordinator
Aetna / Schaller Anderson Inc
03.2011 - 03.2013
Associate of Arts - General Studies Education, Business Administration
Cerritos College
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