Maria Gabriela Rodriguez
Medical Biller
Lancaster,CA
Summary
To obtain a position in a company that will utilize my excellent skills in providing administrative support to other departments in a highly stimulating work environment.
Overview
13
13
years of professional experience
Work History
HMO/Medi-Cal Biller
HospiceMD
02.2019 - Current
- Trained and mentored new team members and managers on accounts payable systems and policies to build cohesive groups and promote operational performance.
- Currently billing for 67 hospice located in Central and Southern California.
- Identified trends in rejections and payer contract issues and communicated to Hospice.
- Skill in efficiently and accurately interpreting explanation of benefits (EOB), including bulk payments and recoupment.
- Handled account payments and provided information regarding outstanding balances by utilizing WayStar, OfficeAlly, Availity.
- Kept vendor files accurate and up-to-date to expedite payment processing.
- Excellent organizational skills and ability to prioritize assignments.
- Monitored outstanding invoices and performed collections duties.
- Knowledge of major medical insurance plans and types of coverage provided.
- Provided outreach for additional information for appeals and grievances and CIF's to payer and also followed Medi-Cal and NUBC billing guidelines.
- Submitted verbal and written notification to members and providers.
- Carried out day to day duties accurately and efficiently.
Supplies Fulfillment Lead
Image Source/Xerox
02.2012 - 01.2019
- Meet quota each month for developing new leads for sales professionals.
- Trained, coached, mentored and supervised large team of professionals also engaged in data entry, customer service.
- Developed relationships with customers, vendors, utilized auditing skills to identify fraudulent activities to prevent losses worked alongside all Government,Unified School Districts and all Aurora Hospitals.
- Documented finished work, including work volumes produced, materials used and any incidents or time lost to keep supervisors informed of production activities.
Return Goods Authorizations
Nexgrill IndustryNexgrill Industry
11.2010 - 02.2012
- Managed relationships with key industry partners and implemented promotional initiatives to maximize marketing program performance for all store and online returns.
- Preserved brand integrity by monitoring consistency and quality of marketing content.
- Place orders for Lowe's through LOS system, Contact Sam's Club for defective unit reasons. Daily incoming report.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
Education
Associate of Science - Medical Administration Specialist
Platt College
Ontario, CA11.2014
Skills
- Knowledge of HIPPA & OSHA
- SolAce EMC
- UB-04(CMS 1500)
- Knowledge of ICD-9 & ICD-10
- Office Ally
- Waystar
- Medical Coding
- CPT Coding
- Medical Billing
- Auditing
- Documentation review
- Medical Terminology
- ICD Coding
- Medical Records
- Insurance Verification
- Accounts Receivable
- Cerner
- Written Communication
Timeline
HMO/Medi-Cal Biller
HospiceMD
02.2019 - Current
Supplies Fulfillment Lead
Image Source/Xerox
02.2012 - 01.2019
Return Goods Authorizations
Nexgrill IndustryNexgrill Industry
11.2010 - 02.2012
Associate of Science - Medical Administration Specialist
Platt College
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