Luz Romero
Modesto,CA
Summary
Detail-oriented and methodical Medical Biller/Follow up representative offering 24 years of experience in related roles. Exceptional abilities in conducting research, problem-solving and prioritizing simultaneous tasks. Leverages resourcefulness, critical thinking skills and superior work ethic for top job performance.
Overview
24
24
years of professional experience
Work History
Billing Specialist
San Joaquin County General Hospital
03.2024 - Current
- Identify, research, and resolve billing variances to maintain system accuracy and currency.
- Work with multiple departments to check proper billing information such Revenue Integrity, HIM, Utilization Management and Patient Access.
- Prepare itemized statements, and medical records to mail with claims certified as well as faxing or uploading to insurance portals
- Work various reports such as daily payment and adjustment reports, monthly priority reports, month end and high dollar reports.
Commercial Billing Supervisor
San Joaquin General Hospital
07.2024 - 02.2025
- Printed all Commercial, Medicare Advantage, Inmate and contract claims daily and forwarding to the appropriate billers.
- Created and modified daily payment and adjustment excel spread sheet reports and forward to appropriate follow up reps.
- Attended daily leadership meetings with various departments to discuss and resolve issues to maintain system accuracy and standard processes.
- Created weekly team meetings to go over my teams questions, provide updates on updates received from leadership and any new processes as well as quick overview of priorities for the week.
- Delegated tasks to administrative support staff to organize and improve office efficiency.
- Helping staff with work as needed
- Met with my team once a month to go over their performance and any concerns
Account Representative
Conifer Healthcare Solutions/Tenet Health
06.2017 - 01.2023
- Analyzed accounts for delinquencies and other ongoing issues.
- Worked Biller queues, control ID, work list, final bill not dropped and aging reports.
- Checked claim status on provider portals, made phone calls to insurance companies.
- Resubmitted corrected claims and appealed as necessary
- Medi-cal FFS and Managed Medi-cal billing and follow up
- Worked as an authorization representative, worked on referrals from primary care physicians, obtained authorizations for office visits and in office procedures as well as Urgent Care services.
Insurance Biller 111
Dameron Hospital
04.2015 - 06.2017
- Medi-cal FFS initial billing and follow up
- Verified eligibility with share of cost clearance as necessary
- Work list, aging, billing and unbilled reports
- Phone calls to patients and Medi-cal
Education
Certificate of Completion - Coding
Delomar
Lathrop, CA01-2023
Certificate - Medical Front Office Specialist
Andon/Kaplan College
Modesto, CA06-2001
High School Diploma -
San Jose High Academy
San Jose, CA06-1996
Skills
- Bilingual; Spanish and English, 10-key, billing cycle management, accounts receivable, attention to detail, auditing, business correspondence, CPT and ICD10 knowledge, data entry, physician and hospital billing Microsoft Office, Excel
Timeline
Commercial Billing Supervisor
San Joaquin General Hospital
07.2024 - 02.2025
Billing Specialist
San Joaquin County General Hospital
03.2024 - Current
Account Representative
Conifer Healthcare Solutions/Tenet Health
06.2017 - 01.2023
Insurance Biller 111
Dameron Hospital
04.2015 - 06.2017
Certificate of Completion - Coding
Delomar
Certificate - Medical Front Office Specialist
Andon/Kaplan College
High School Diploma -
San Jose High Academy