Mari Parra

• Managed all aspects of the revenue cycle, including preparing, submitting, and following up on claims to insurance companies, government payers, and other third-party entities.
• Ensured accurate medical coding in compliance with relevant standards (e.g., ICD-10, CPT).
• Conducted regular chart audits to ensure documentation compliance and accuracy in billing practices.
• Proficiency in insurance plan coverages, benefits, and payer coverage policies, to ensure accurate claims submission and reimbursement.
• Prior authorization requests to various insurance payers ensure that medical procedures, treatments, and services are covered under patient insurance plans.
• Overseen the processing of high claims volumes, ensuring timely and accurate submissions that align with payer requirements and contract terms.
• Review and resolve insurance denials, using in-depth knowledge of insurance coverage policies and benefits to appeal denials, and recover revenue.
• Leading efforts in managing and appealing denied claims, ensuring claims are submitted with complete and accurate information, in compliance with payer policies.
• Analyzed and managed insurance contract terms to ensure billing and coding practices align with the terms, reimbursement structures, and payer coverage policies outlined in contracts.
• Developed strategies to reduce claim denials by enhancing knowledge of payer coverage guidelines and ensuring claims are submitted correctly the first time.
• Audits on billing and claims submission processes to ensure compliance with payer guidelines and regulatory standards.
• Managed and mentored a large team of billing specialists, providing ongoing training, support, and performance management to ensure high accuracy and efficiency.
• Set clear expectations for staff performance and productivity, ensuring alignment with organizational goals and quality standards.
• Ongoing training for the billing team on insurance policies, payer coverage, claims processing, denial management, prior authorizations, and industry best practices.
• Monitored and assessed team performance using key metrics, conducted regular performance reviews, identified areas for improvement, and implemented corrective actions as needed.
• Prepared and presented detailed reports on key performance metrics (KPIs), such as denial rates, claim submission accuracy, revenue cycle performance, and appeals outcomes.
• Build and maintain strong relationships with insurance payers to ensure smooth claims resolution, and address issues related to payer coverage policies and reimbursements.
• Collaborated with hospitals, physicians, insurance companies, and internal departments to resolve billing issues, ensure accurate coding, and improve revenue cycle performance.
• Electronic billing submission.
• Payment Posting

Reviewed and followed up on submitted UB04 claims for various payers, including Managed Care and Medicare.

Managed denial appeals, both written and oral, for underpayments based on contractual agreements.

• Utilized ICD-9 and CPT codes to accurately illustrate diagnoses and procedures.
• Organized inpatient and outpatient claims for electronic and hard copy submission.
• Processed accounts receivable, including payment posting and charge entry.
• Handled refunds and initiated collections on outstanding accounts.
• Provided interpretation assistance in Spanish for non-English speaking patients.

• Applied ICD-9 and CPT codes for accurate billing and record-keeping.
• Managed patient phone calls to address inquiries and concerns.
• Followed up on outstanding accounts to ensure timely resolution.
• Processed EOBs, denials, and appeals to maintain financial accuracy.
• Conducted accounts receivable research for credit balances and refunds.
• Executed refunds on credit balances to uphold customer satisfaction.
• Posted payments efficiently to streamline financial operations.