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
West Covina, CA
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
Chino Hills, CA
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