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Hi, I’m
Lorraine Parra
Medical Billing Manager
Morgan Hill,CA
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Summary
Hardworking Billing Manager proficient in overseeing team operations, implementing improvements and reducing delinquency. Offering 15 years of experience in medical billing industry with excellent communication and billing software skills.
Overview
15
years of professional experience
1
Certification
1
Language
Work History
Eye Medical Clinic of Santa Clara Valley
Medical Billing Manager
07.2019 - Current
Job overview
- Performed billing, collection, and reporting functions for office generating over $4.6 million annually. Reviewed billing problems, researched issues, and resolved concerns.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Expert resource on complex patient account issues or high-dollar claims requiring specialized handling, ultimately resolving outstanding balances in efficient manner.
- Performed banking, business administration and financial tasks to guarantee five-star service for clients.
- Utilized financial software to prepare consolidated financial statements.
- Trained and mentored staff on procedures, compliance requirements, and collections techniques.
- Worked with customers to develop payment plans and bring accounts current.
- Increased patient satisfaction by addressing billing inquiries promptly and professionally.
- Reduced denied claims through diligent review, correction, and resubmission of errors.
- Developed strong relationships with insurance companies through effective communication and negotiation skills, enhancing payment turnaround times.
- Maintained up-to-date knowledge of regulatory changes impacting medical billing practices to ensure ongoing compliance within organization.
- Streamlined claim appeals process by creating clear documentation guidelines and templates for staff use.
- Enhanced revenue cycle management by overseeing timely and accurate claims submission.
- Trained team members on best practices in medical billing, ensuring consistent high-quality work across departments.
- Developed policies and procedures for medical billing department, establishing strong foundation that supported growth and operational success within organization.
- Collaborated with providers and staff to ensure accurate coding for billing purposes.
- Improved accuracy of medical coding by thoroughly reviewing patient records and assigning correct codes for diagnoses and procedures.
- Optimized cash flow by regularly reviewing aging account balances and implementing tactics for timely collections from patients or insurers.
- Facilitated cross-departmental collaboration between clinical teams as well as finance and administrative staff to ensure seamless integration of billing-related tasks into daily workflows.
- Verified, coded and added modifiers to diagnoses.
DMSCO, INC
Medical Coder and Biller/Account Lead
06.2014 - 06.2019
Job overview
- Responsible for billing, coding, and accounts receivable of cardiovascular and general surgery accounts that generates average of $500,000 per month
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Maintained high level of productivity while consistently meeting deadlines for claim submissions.
- Ensured compliance with industry regulations and guidelines by staying up-to-date on latest coding changes.
- Collaborated with physicians to obtain necessary documentation, improving claim approval rates.
- Enhanced team efficiency with regular training sessions on new coding updates and best practices.
- Supported implementation of electronic health record systems, simplifying coding process.
- Promoted teamwork within department through effective communication and collaboration on complex cases.
- Performed on-site coding audits to determine accuracy and compliance with coding guidelines.
- Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
- Minimized errors by providing ongoing feedback to clinical staff regarding proper documentation practices.
- Reduced claim denials by maintaining thorough knowledge of payer-specific requirements and guidelines.
- Reduced turnaround time for appeals by preparing comprehensive supporting documentation for denied claims.
- Streamlined billing process for faster reimbursement by submitting accurate and timely insurance claims.
- Expedited claim resolution with insurance companies through clear communication and prompt follow-up actions.
- Verified signatures and checked medical charts for accuracy and completion.
- Contributed to revenue growth by identifying under coded services for proper reimbursement.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Prevented costly fines by ensuring adherence to HIPAA regulations when handling sensitive patient information.
- Boosted patient satisfaction with transparent explanations regarding their billing statements, addressing any concerns promptly.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Followed up with medical staff regarding missing information in patient records.
- Checked insurance eligibility by making appropriate phone calls and conducting research on services rendered.
- Developed strong relationships with clients, fostering trust and effective communication regarding billing matters.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
AVORS Medical Group
Billing Supervisor/Medical Coder
06.2009 - 06.2014
Job overview
- Reduced discrepancies in billing reports with thorough review processes and diligent follow-ups on outstanding accounts.
- Minimized errors in customer billing information through diligent verification practices and prompt issue resolution.
- Managed preparation and distribution of customer invoices within strict deadlines, upholding adherence to company policies and client agreements.
- Created detailed reports for management reflecting key financial indicators such as receivables aging analysis, uncollected revenues breakdowns, write-offs statistics, among others contributing valuable insights into department''s strengths and weaknesses.
- Oversaw proper allocation of payments received from various sources, ensuring accurate posting to relevant accounts and facilitating efficient reconciliations at month-end.
- Developed comprehensive training materials for new hires to ensure smooth onboarding process and rapid acclimation to company systems and procedures.
- Facilitated monthly meetings with team members to discuss performance metrics, share best practices, and address any concerns or challenges faced during billing cycle.
- Boosted cash flow by identifying areas for improvement in payment terms enforcement and initiating corrective actions as needed.
- Performed account reconciliations and resolved variances.
- Proactively identified potential bottlenecks in billing process, implementing solutions that increased overall operational efficiency.
- Collaborated closely with other departments, fostering strong working relationships to expedite resolutions of cross-functional issues impacting revenue collection.
- Maintained high level of customer satisfaction by addressing inquiries promptly, resolving issues effectively, and consistently delivering accurate invoices within established timeframes.
- Negotiated with customers regarding payment arrangements when necessary, balancing firmness with empathy to maintain positive relationships without sacrificing revenue collection targets.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Provided backup to front desk to step in to assist with various tasks whenever employee was absent or at lunch.
- Promoted teamwork within departments through effective communication and collaboration on complex cases.
- Managed approximately 30 incoming calls, emails and faxes per day from customers.
Education
DeVry University, Chicago
Bachelor’s in Business Administration from Business Administration
05.2023
University Overview
- Dean's List
- 4.0 GPA
- National Society of Leadership and Success Member
- summa cum laude graduate
Skills
- HIPAA Compliance Knowledge
- Claims Processing Proficiency
- Patient Confidentiality Practices
- Team Leadership Qualities
- Electronic Health Records Experience
- Medical Coding Expertise
- Revenue Cycle Management
- Denial Management Strategies
- ICD-10 Familiarity
- CPT Coding Understanding
- Medical Billing Software Mastery
- Collections experience
- Training and mentoring
Certification
- AAPC CPC Certified
Accomplishments
- Onboarded multiple doctors, while successfully credentialing and contracting them with the required insurance companies.
- Researched insurance changes annually, which reduced income loss.
- Coded surgeries with accuracy, utilizing Codify and NCCI edits to ensure that the appropriate modifiers are used as well as demand prompt payment of claims and reduced denial of high dollar claims.
- Created office policies that aligned with the most up to date insurance changes to ensure optimal collections.
- Created “How To” manuals for other employees to review when in need of training.
- Documented and resolved low collections in the early months of the year due to high patient deductibles which led to higher collections in the months of January and February.
References
Promptly furnished upon request.
Additional Information
I am proficient in Microsoft office, including Word, Excel, and Powerpoint. I have extensive knowledge of Medicare, Medi-Cal, and commercial insurances including appeals processes and coding requirements.
Availability
See my work availability
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Available
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Work Preference
Work Type
Full TimeWork Location
RemoteImportant To Me
Career advancementHealthcare benefitsWork from home optionPersonal development programsAffiliations
- Morgan Hill Chamber of Commerce
- Calaveras County Chamber of Commerce
- National Society of Leadership and Success
Software
Google Drive Applications
Nextech PM and EMR
Epic
Interests
Reading
Excersise
Community involvement
Timeline
Medical Billing Manager
Eye Medical Clinic of Santa Clara Valley
07.2019 - Current
Medical Coder and Biller/Account Lead
DMSCO, INC
06.2014 - 06.2019
Billing Supervisor/Medical Coder
AVORS Medical Group
06.2009 - 06.2014
DeVry University
Bachelor’s in Business Administration from Business Administration
- AAPC CPC Certified
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