Maricela Castro
Moreno Valley,CA
Summary
Medical billing professional with extensive experience in managing patient billing processes and ensuring timely claim submissions. Known for strong collaboration within teams and delivering reliable outcomes. Possesses deep knowledge of coding standards and insurance guidelines, coupled with client-focused approach.
Overview
26
26
years of professional experience
Work History
Medical Billing Specialist
Brault
San Dimas, CA
09.2015 - Current
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Identified and resolved patient billing and payment issues.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Prepared appels to denied claims.
- Review patient bills for accuracy and completeness and obtain any missing information.
- Knowledge of insurance guidelines, including HMO/PPO, Medicare and state Medicaid.
- Follow up on unpaid claims within standard billing cycle timeframe.
A/R Specialist
Desert Trauma Surgeons, Inc.
Lynwood, CA
10.2022 - 01.2026
- Managed accounts receivable processes to ensure timely invoicing and collections.
- Collaborated with cross-functional teams to resolve billing discrepancies efficiently.
- Reviewed accounts with credit balances and request refunds as needed.
- Worked rejections and EOB denial queue.
- Filed appeals for Medicare, Medi-Cal and non-contracted providers.
Medical Billing Specialist
Brault
San Dimas, CA
09.2015 - 09.2022
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Identified and resolved patient billing and payment issues.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Prepared appels to denied claims.
- Review patient bills for accuracy and completeness and obtain any missing information.
- Knowledge of insurance guidelines, including HMO/PPO, Medicare and state Medicaid.
- Follow up on unpaid claims within standard billing cycle timeframe.
Medical Biller
Marina Medical Billing
Cerritos, CA
03.2000 - 09.2015
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Filed and updated patient information and medical records.
- Prepared accounts with past due balances and transferred those cases to collection agency.
- Check eligibility and benefit verification.
- Review and process refunds.
- Follow up on unpaid claims within standard billing cycle timeframe.
Education
GED -
Moreno Valley Community Adult School
Morongo Valley, CASkills
- Reviewing Patient Information
- Medicare and Medicaid Processes
- Billing Data Verification
- Emergency Room Services
- Trauma Room Services
- Patient Collections
- Workers' Compensation Knowledge
- CMS-1500 Billing Forms
- Electronic Claims
- Claim Verifications
- Time Management
- Excel, create and maintained spreadsheets
- Knowledge of paper and electronic claim requirements
Timeline
A/R Specialist
Desert Trauma Surgeons, Inc.
10.2022 - 01.2026
Medical Billing Specialist
Brault
09.2015 - Current
Medical Billing Specialist
Brault
09.2015 - 09.2022
Medical Biller
Marina Medical Billing
03.2000 - 09.2015
GED -
Moreno Valley Community Adult School