MARICELA GAMA
Fullerton,CA
Summary
Detail-oriented medical insurance biller with extensive experience in claims processing. Proven ability to streamline operations, enhance billing accuracy, and optimize reimbursement timelines.
Overview
20
20
years of professional experience
Work History
MEDICAL INSURANCE BILLER
ALEEM A SYED MD A PROFESSIONAL CRP
Anaheim, CA
08.2005 - 12.2025
- Processed medical insurance claims with accuracy to ensure timely reimbursements.
- Reviewed patient accounts for completeness and compliance with billing regulations.
- Coordinated with healthcare providers to resolve claim discrepancies and denials.
- Analyzed billing data to identify trends and implement process improvements.
- Managed accounts receivable, reducing outstanding claims through proactive follow-up.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Prepared detailed monthly reports highlighting key metrics such as collections ratio, days in accounts receivable, and percentage of aged accounts for management review.
- Optimized the use of practice management software systems for more efficient claim generation and submission processes.
- Participated in regular audits of billing processes to maintain high-quality performance standards and identify areas for improvement.
- Reduced claim denials by effectively communicating with healthcare providers to obtain necessary documentation and information.
- Expedited payment turnaround time with efficient follow-up on outstanding claims, addressing issues as necessary.
- Ensured timely reimbursement for services by submitting clean claims to insurance carriers promptly.
- Streamlined claim processing for faster payments by maintaining accurate patient records and insurance information.
- Improved patient billing accuracy by diligently reviewing and editing medical insurance claims.
- Verified insurance of patients to determine eligibility.
- Posted payments and collections on regular basis.
- Monitored outstanding invoices and performed collections duties.
- Maintained accurate records of customer payments.
- Generated monthly billing and posting reports for management review.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Created improved filing system to maintain secure client data.
Education
FULLERTON COMMUNITY COLLEGE
Fullerton, CALanguages
Spanish
Native or Bilingual
Timeline
MEDICAL INSURANCE BILLER
ALEEM A SYED MD A PROFESSIONAL CRP
08.2005 - 12.2025
FULLERTON COMMUNITY COLLEGE