Luz Hernandez
Hesperia
Summary
Experienced remote medical biller and coder with over 3 years of clinical work knowledge in a highly skilled healthcare facility. Known for efficient workflow and strong management of claim submission and processing, enhancing reimbursement satisfaction within a timely manner. Often reviewing patient accounts and navigating billing system to ensure accuracy.
Overview
9
9
years of professional experience
Work History
Medical Biller and Coder - Remote
Foothills Pain Management Clinic
Covina, CA
06.2018 - Current
- Reviewed claims prior to submitting to insurance companies.
- Verified patient eligibility.
- Managed patient accounts; review of balances for accuracy.
- Verified patient co-pays, deductibles and secondary insurances.
- Knowledgeable with HMOs, PPOs and Medicare insurances.
- Follow-up on pending claims for reimbursement accuracy.
- Experienced in ICD-10, CPT and HCPCS.
- Corrected claims with ICD-10 and CPT
- Submitted claims regarding office, surgery center and nursing homes.
- Verified patient coverage benefits; start and end dates.
- Processed claims for PI's/Workers Comps.
- Resourcefully used updated CMS correspondence for new and up to date claim changes
- Applied payments from ERA's and patients.
- Communicated with office staff and providers for accurate documentation regarding services rendered.
- Assisted patients with understanding their insurance benefits, coverages and financial responsibilities.
- Communicated with insurance companies and medical groups to resolve outstanding claims.
- Monitored changes in insurance coverages to optimize denials.
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
- Followed up with medical staff regarding missing information in patient records.
- Verified accuracy of patient information in medical records.
- Transcribed and entered patient medical information into electronic medical records systems.
- Use EMR/EHR and PM (Allscripts and Kaero)
Medical Assistant
Foothills Pain Management Clinic
Covina, CA
06.2018 - Current
- Administered patient care, including vital signs monitoring and medical history documentation.
- Assisted healthcare providers in patient examinations and procedures to enhance workflow efficiency.
- Coordinated patient appointments.
- Coordinated patient procedure appointments.
- Front desk check-in.
- Collected copays.
- Trained new staff on office protocols and work flow.
- Sanitized, restocked, and organized exam rooms and medical equipment.
- Obtained client medical history, medication information, symptoms, and allergies.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Performed medical records management, including filing, organizing and scanning documents.
- Built relationships with patients through communication to ensure trust.
- Maintained a safe and clean clinical environment by adhering to infection control guidelines and disposing of biohazardous waste properly.
- Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
- Coordinated patient referrals to specialists, procedures and medication.
- Obtained accurate insurance coverage, authorizations and current eligibility to reduce wait times.
- Prepared and processed UDT specimens for diagnostic testing.
- Taught patients about medications, procedures, and care plan instructions.
- Assisted billing with collecting patient balances.
- Used EHR/EMR systems (Allscripts and Kaero)
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
Administrative Assistant
Foothills Family Medical Clinic
Fontana, CA
05.2017 - 05.2018
- Coordinated patient appointments.
- Verified patient eligibility.
- Managed paper health records.
- Trained new staff on electronic system, clinic guidelines and procedures.
- Experienced in using multi-line phone system.
- Improved document organization by updating patient charts.
- Supported and assisted staff by answering question and concerns.
- Optimized provider calendar managing priorities, meetings and filling up schedule.
- Created patient authorizations.
- Managed provider phone and email correspondence and handled incoming and outgoing mail and faxes.
- Assisted coworkers and staff members with special tasks on daily basis.
- Completed forms, reports, logs, and records for patient medical records.
- Increased office participation in daily task and goals for patient satisfaction.
- Managed clinic performance.
Education
Medical Assistant
American Career College
CA04-2018
Skills
- HIPAA compliance and training
- Payment posting
- Insurance verification
- CPT, ICD‑10, HCPCS proficency
- Claims submission (electronic)
- Denial management/review
- Prior authorizations
- EOB review
- Familiarity with Medicare, Medi‑Cal, PPO, HMO
- EMR/EHR systems (Allscripts and Kareo)
- Time management
- Customer service (patient billing questions)
- Bilingual
Timeline
Medical Biller and Coder - Remote
Foothills Pain Management Clinic
06.2018 - Current
Medical Assistant
Foothills Pain Management Clinic
06.2018 - Current
Administrative Assistant
Foothills Family Medical Clinic
05.2017 - 05.2018
Medical Assistant
American Career College