MARIA SILLER
Arlington,Texas
Summary
Dedicated 20 years to providing quality care for ultimate customer satisfaction in the medical field. Proven ability to establish and maintain excellent communication and relationships with clients. Adept in general accounting. Dedicated to identifying customer needs and delivering effective solutions to all problems. Excellent time management skills combined with a superior knowledge of the customer service industry. Bilingual, hardworking, and ready to join my next team.
Overview
25
25
years of professional experience
Work History
Reimbursement Specialist
University of Texas Southwestern Hospital
Dallas, TX
04.2023 - Current
- Maintained confidentiality and integrity of patient data.
- Researched rejections, investigating problems to appeal claims.
- Determined medical necessity, using individual insurance carrier regulations.
- Verified technical reimbursement questions for providers, billing and coding staff.
- Drafted documents based on payer guidelines and submitted to necessary parties.
- Reviewed uninsured accounts, verifying medical assistance application process, charity care application and drug replacement program availability.
- Advised supervisors and clinicians of billing deficiencies to support charge capture.
- Worked with billing department to reduce contract implementation errors.
- Educated physicians, staff, patients and stakeholders on service documentation for procedures and coding requirements.
- Maintained a database of all reimbursements, payments, and other transactions.
- Reviewed and processed reimbursement requests in accordance with company policies and procedures.
- Investigated complex cases involving multiple providers or incorrect coding issues.
- Verified that all necessary documents were included in each request before submitting it for payment.
- Analyzed patient data to ensure accuracy of reimbursement information.
- Resolved discrepancies between provider documentation and insurance plan requirements.
- Assisted in developing new processes for more efficient management of reimbursement requests.
- Provided training to new staff on the proper submission process for reimbursement requests.
- Submitted claims to insurance companies.
- Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
- Performed insurance verification, pre-certification and pre-authorization.
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
- Checked claims coding for accuracy with ICD-10 standards.
- Input statement information, reconciled accounts and resolved discrepancies.
- Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology.
SPL Verification PAIC
Texas Health Resources
Arlington, TX
04.2019 - 03.2023
- Provided quality coordination services to one of the busiest medical centers in the area
- Developed and managed relationships with professional medical leaders
- Communicate with Medical Insurance Companies regarding verification and pre-certification to coordinated patient care
- Attended seminars to remain up-to-date with coding guidelines and reimbursement requirements.
- Helped to maintain meticulous medical records, and made changes when necessary
Front and Back office medical assistant
Neurology Consultants
Arlington
04.1999 - 02.2018
- Communicated with patients and families to alleviate concerns and inform people of a patient's status
- Treated patients and families with kindness and compassion
- Provided superior support to administrative and medical personnel
- Served as a direct assistant to physician supporting all aspects of patient care and office management
- Helped to maintain meticulous medical records, and made changes when necessary
- Managed all patient documents including insurance filing and billing
- Handled paperwork, billing, and scheduling
- Helped to manage and resolve billing disputes and collections.
Education
High School diploma -
Paramount High School
06.1994
Skills
- Microsoft Excel Expert
- Computer Skills Expert
- Customer Service Expert
- Communication Skills Expert
- Communication Expert
- Ability to Multitask Expert
- Fast Learner Expert
- Effective Time Management Expert
- Leadership Expert
- Adaptability Expert
- Microsoft Office Expert
- Ability to Work Under Pressure Expert
- Ability to Work in a Team Expert
Languages
Spanish Highly proficient
References
- Julio Hernandez, 214-662-6754, Julio.Hernandez@huntersindustries.com
- Roxanna Ortiz, 682-236-1321, roxannaortiz@texashealth.org
Hobbies and Interests
- Soccer
- Hiking
- Fishing
- Running
- Traveling
Timeline
Reimbursement Specialist
University of Texas Southwestern Hospital
04.2023 - Current
SPL Verification PAIC
Texas Health Resources
04.2019 - 03.2023
Front and Back office medical assistant
Neurology Consultants
04.1999 - 02.2018
High School diploma -
Paramount High School