MARIA CONSUELO TOVIAS
MISSION,TEXAS
Summary
Coding and Billing Specialist with proven expertise in account management and billing optimization. Skilled in leveraging databases for billing processes, insurance verification, and preauthorization. Achievements include enhanced account collections and strengthened client relationships through effective organizational and problem-solving abilities. Dedicated to maintaining precise records and providing exceptional client service.
Overview
43
43
years of professional experience
Work History
Billing Specialist
Doctors Hospital at Renaissance
Edinburg, Texas
02.2023 - Current
- Worked as a Billing Specialist.
- I am responsible for doing Verification of Benefits online, obtaining diagnosis codes and obtaining preauthorizations.
- Scanning and faxing out various documents.
- Documenting the system for the Benefits for each patient to ensure proper collection after insurance pays.
- At the present I am responsible for obtaining preauthorizations on all accounts that come into the clinic for physical therapy including Medicare, Medicaid, Commercial insurances, Exchange insurances, Triwest, and workers compensation.
Assistant Manager
S & F Developers
Mission, Texas
05.2022 - 02.2023
- Handled payments for lots, HOA fees, and car lot services with precision.
- Maintained accurate records of sales transactions via point-of-sale systems.
- Created detailed reports on sales trends, inventory levels, and financial metrics.
- Developed efficient tracking system for inventory management and supply orders.
- Addressed tenant issues and inquiries promptly to ensure satisfaction.
- Established processes for assessing customer satisfaction through feedback mechanisms.
- Organized incoming mail effectively by separating bills from junk mail.
- Compiled loan and interest reports for CPA's income tax preparation diligently.
Billing Office Specialist
Doctors Hospital at Renaissance
Edinburg, Texas
06.2018 - 05.2022
- Worked as a Billing Office Specialist.
- I am responsible for doing Verification of Benefits online, obtaining diagnosis codes and correcting claims.
- Scanning and faxing out various documents.
- Documenting the system for the Benefits for each patient to ensure proper collection after insurance pays.
- I am also responsible for taking payments over the phone for both client and patients.
- Providing self pay and client prices for various lab tests.
- At the present I am responsible for billing and correcting any account that falls in my workout including Medicare, Medicaid and Commercial insurances.
Insurance & Self Pay Collector
Mission Regional Medical Center
Mission, Texas
06.2002 - 06.2017
- Executed follow-up on all commercial insurances to ensure timely processing of claims.
- Verified information for collection purposes and confirmed benefits with insurance providers.
- Processed refunds, mailed statements, and adjusted financial class to self-pay when necessary.
- Collected co-payments, deductibles, and co-insurances while completing payment arrangements.
- Maintained accurate records of all collection activities in the system database.
- Prepared monthly reports summarizing collections activity for management review.
- Negotiated payment arrangements with customers past due on accounts to facilitate recovery.
- Provided guidance to customers facing financial difficulties regarding billing inquiries.
Billing Clerk/Receptionist
Family Health Center of Mission
Mission, Texas
04.2002 - 06.2002
- Obtained any necessary information to process claims.
- Check on claim status.
- Entered charges, adjustments and requested information to obtain payment from insurances.
- Created new patient files with all the pertaining information.
- Called to request benefits and collected deductibles and coinsurance or copayments.
Billing Coordinator/Outpatient Counseling Center Office Manager
Charter Palms Hospital
McAllen, Texas
01.1987 - 01.1995
- Data Entry, Receptionist, Office Manager for the Outpatient Counseling Centers.
- Collected any Patient responsibility and billed insurances for services rendered.
- Participated in marketing functions for the counseling centers and hospital.
Billing/Admissions Clerk
McAllen Medical Center
McAllen, Texas
01.1983 - 01.1987
- Billed all commercial insurances ensuring that nothing was missing.
- Assisted with Blue Cross and Medicare and Medicaid billing.
- When needed would help out with the Admissions Department in registering patients that were waiting in the Admitting area.
Education
High School Diploma -
Mission High School
Mission, TexasCoding and Billing Specialist -
The College of Health Care Professions
McAllen, TexasSkills
- Bilingual
- Coding proficiency
- Records organization and review
- Proficient in billing
- Preauthorizations
- Collections
- Detail-oriented
- Organized
- Knowledgeable of Medical Terminology
- Ability to work independently
- Coachable
- Willing to be trained
- Proficient in Billing & Verifying benefits
- Cross-trained
- Marketing
- Networking
- Knowledgeable of Medicare
- Knowledgeable of Medicaid
- Experience with HMO's
- Experience with PPO's
References
- Eleazar Fernandez, Friend/neighbor, 1208 Hunter Street, Mission, TX, 78572, (956) 581-4673
- Maritza Perez, Cashier Supervisor, Mission Regional Medical Center, 4409 Whitney Circle, Mission, TX, 78572, (956) 445-4360
- Raul Cruz, Manager, Arrow Auto Sales, 504 E 9th Street, Mission, TX, 78572, 956-360-3757
Languages
English
Professional
Spanish
Professional
References
References available upon request.
Timeline
Billing Specialist
Doctors Hospital at Renaissance
02.2023 - Current
Assistant Manager
S & F Developers
05.2022 - 02.2023
Billing Office Specialist
Doctors Hospital at Renaissance
06.2018 - 05.2022
Insurance & Self Pay Collector
Mission Regional Medical Center
06.2002 - 06.2017
Billing Clerk/Receptionist
Family Health Center of Mission
04.2002 - 06.2002
Billing Coordinator/Outpatient Counseling Center Office Manager
Charter Palms Hospital
01.1987 - 01.1995
Billing/Admissions Clerk
McAllen Medical Center
01.1983 - 01.1987
High School Diploma -
Mission High School
Coding and Billing Specialist -
The College of Health Care Professions
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