Lupe Juarez
Colton,CA
Summary
Detail-oriented Medical Insurance Billing Specialist with a strong background in claims processing, billing compliance, and account analysis. Proven track record of resolving collection issues and ensuring accurate payment application to enhance efficiency and maximize reimbursement rates.
Overview
27
27
years of professional experience
Work History
Collector
Loma Linda University Health Care
Loma Linda, USA
03.2012 - Current
- Experience in A/R collections and billing, working projects, involving commercial insurance, IPAs, HMO, PPO, Medicaid, Medicare, Managed Care, Case rates.
- Monitored collection issues and trends, resolving discrepancies with payers to enhance collection efficiency.
- Analyzed and audited accounts for correct balance, followed up on discrepancies, and wrote appeals to secure reimbursement.
- Performs phone online, paper inquiries, and correspondence taking appropriate collection actions; working rejections, denials, call for status, tracer claims, submitted medical records, and rebilling.
- Audits misapplied payments, requests payments, adjustments, transfers, or refunds.
- Verifies patient services are coded correctly and payment applied correctly.
- Performed team lead or billing coordinator duties such as leading a training rollout and providing feedback, as well as assisting coworkers.
- Performed additional tasks to support team objectives.
Collector II(Temporary Position)
Medix Staffing Solutions, Inc.
Irvine, USA
10.2011 - 02.2011
- Managed billing and collections for physicians, ensuring timely revenue flow in healthcare setting.
- Handled insurance claims for commercial plans, IPAs, Medicaid, and Medicare, facilitating accurate reimbursements.
- Experience with the claims process including follow-up for prompt and correct payment.
- Composed detailed appeals to resolve insurance disputes, contributing to improved claim approvals.
Collector I(Temporary Position)
Aerotek
Rancho Cucamonga, USA
07.2010 - 11.2010
- Executed claims processing and followed up, achieving timely and accurate payments.
- Managed physician billing and collections processes, resulting in consistent timely payments.
- Navigated various insurance types, including commercial and government programs, for claims processing.
- Drafted appeals to resolve billing disputes, facilitating proper reimbursement.
Medical Billing Specialist/Collections
Arrowhead Community Surgical Medical Group, Inc.
Redlands, USA
09.2006 - 02.2010
- Managed physician billing and collections, ensuring accuracy and compliance.
- Experience with commercial insurance, IPAs, HMO, PPO, Medicaid, Medicare, workers’ compensation, self-pay.
- Navigated claims process, following up on submissions to secure timely payments.
- Drafted appeals to resolve billing disputes, improving claim approval rates.
- Provided training to new employees and externs on billing procedures and writing appeals to ensure accurate data entry.
Emergency Room Registration Clerk/Admitting
Redlands Community Hospital
Redlands, USA
02.2000 - 05.2003
- Verified insurance eligibility, obtained authorizations, collected deposits/copays, and processed documentation to facilitate smooth patient admissions.
- Registered patients and gathered personal information to streamline check-in process.
- Coordinated with medical staff to enhance patient service delivery and minimize wait times.
- Maintained accurate records in electronic health systems daily.
- Assisted patients with inquiries and provided clear directions.
- Ensured compliance with hospital policies and privacy regulations consistently.
Education
Medical Billing Specialist Diploma -
Bryman College
Ontario, CA09-2006
High School Diploma -
Colton High School
Colton, CA06-1995
Skills
- Payment reconciliation
- Claims processing
- Billing compliance
- Appeals management
- Medical collections
- Audit and analysis
- Problem solving
- Attention to detail
- Dependable and responsible
- Customer service
- Multitasking Abilities
Timeline
Collector
Loma Linda University Health Care
03.2012 - Current
Collector II(Temporary Position)
Medix Staffing Solutions, Inc.
10.2011 - 02.2011
Collector I(Temporary Position)
Aerotek
07.2010 - 11.2010
Medical Billing Specialist/Collections
Arrowhead Community Surgical Medical Group, Inc.
09.2006 - 02.2010
Emergency Room Registration Clerk/Admitting
Redlands Community Hospital
02.2000 - 05.2003
Medical Billing Specialist Diploma -
Bryman College
High School Diploma -
Colton High School