Marisela Castelan
Alton,Texas
Summary
To obtain a position in the Medical Administrative Field in which I may can continue to expand my knowledge in the administration of any entity. QUALIFICATIONS: 25+ yrs experience providing comprehensive support in Medical/Business Office. Have demonstrated ability to identify, analyze, and solve problems efficiently. Have proven the ability to work independently or as a team player. Quick learner, rapidly adapt to and master new responsibilities
Overview
16
16
years of professional experience
Work History
Billing Specialist
OPTUM/UHG
06.2022 - Current
- Out of state Medicaid Billing
- Worked effectively with several out of state Medicaid and MCOs to obtain timely and accurate payments.
- Monitored outstanding claims and performed collections duties.
- Audited and corrected billing and posting documents for accuracy.
- Posted claim payments and provided information regarding outstanding balances.
- Developed and maintained billing procedures to make timely payments.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Monitored customer accounts to identify and rectify billing issues.
- Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
- Researched and resolved billing discrepancies to enable accurate billing.
Practice Manager
Urology Institute DHR
05.2019 - 12.2020
- Managed daily practice operations to optimize appointment scheduling, patient records management and billing functions.
- Provided outstanding support to entire staff which helped improve process flow and boosted efficiency.
- Addressed and remedied all patient or team member issues.
- Developed close working relationships with front office and back office staff.
- Supervised team of 70+ office personnel.
- Communicated closely with patients, ensuring medical information was kept private.
- Implemented successful healthcare program through professionalism, quality of care, medical teaching and patient satisfaction.
- Ordered all office supplies and kept check on inventory levels
Appeals Supervisor
DHR
08.2014 - 05.2019
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Monitored workflow to improve employee time management and increase productivity.
- Evaluated employee performance and coached and trained to improve weak areas.
- Achieved results by working with staff to meet established targets.
- Supervised team of 10 office personnel.
- Ensured appeals were going out timely to increase revenue flow
Billing Supervisor
DHR
03.2012 - 08.2014
- Coordinated with other internal departments and customers to keep operations running smoothly and solve both routine and complex problems.
- Developed and implemented improvements to billing system to maximize efficiency, reduce delinquency and increase accuracy.
- Assisted with billing inquiries and provided timely responses to employees.
- Worked with multiple departments to check proper billing information.
- Supervised team of 10 office personnel.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Assisted with billing inquiries and provided timely responses to enhance customer satisfaction
- Developed and implemented improvements to billing system to maximize efficiency, reduce delinquency and increase accuracy
Business Office Auditor
DHR
10.2010 - 03.2012
- Resolved financial discrepancies and customer billing issues with timely attention.
- Prepared working papers, reports and supporting documentation for audit findings.
- Researched medical records for questions patients has regarding billed items.
Governmental Biller
DHR
08.2007 - 10.2010
- Executed billing tasks and recorded information in company databases.
- Kept all patient information secure and confidential.
- Followed up with appropriate parties to obtain prompt payments.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Checked insurance eligibility by making appropriate phone calls and conducting research on services rendered.
- Researched and resolved billing discrepancies to enable accurate billing.
- Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
Education
High School Diploma -
Mission High School
Mission, TX05.1990
Registered Medical Assistant - Medical Assistant
SACMDA
McAllen, TX06.1991
Skills
- Bilingual
- Knowledge of basic computer skills(Mac, PC, etc), Excel (pivot tables, etc)
- Synapse, EPIC, CEA FACS, Paragon, Cerner, RELAY Billing System, FISS, AEOS,
- Medisoft, TMHP Network, UNIX, C Meds, Medical Manager, Availity
- Account Posting
- Insurance Confirmation
- Electronic Document Management System
- 10-Key Data Entry
- Submitting Insurance Documents
- Research
- Google Drive
- Medical Billing and Collections
- Billing Dispute Resolution
Languages
Spanish
Native or Bilingual
Timeline
Billing Specialist
OPTUM/UHG
06.2022 - Current
Practice Manager
Urology Institute DHR
05.2019 - 12.2020
Appeals Supervisor
DHR
08.2014 - 05.2019
Billing Supervisor
DHR
03.2012 - 08.2014
Business Office Auditor
DHR
10.2010 - 03.2012
Governmental Biller
DHR
08.2007 - 10.2010
High School Diploma -
Mission High School
Registered Medical Assistant - Medical Assistant
SACMDA
Similar Profiles
Sabrina LeeSabrina Lee
Senior Business Project Manager at Optum/UHGSenior Business Project Manager at Optum/UHG
Anshul MalikAnshul Malik
Manager Software Engineering at Optum Global Solutions (UHG)Manager Software Engineering at Optum Global Solutions (UHG)
Sridevi KrishnamurthySridevi Krishnamurthy
Team Leader - Project Management/SME Team Leader at UHG, United Health Group/OPTUMTeam Leader - Project Management/SME Team Leader at UHG, United Health Group/OPTUM