MARLENE GARCIA
DALY CITY,CA
Summary
Adept at enhancing revenue collections and reducing claim denials, I leveraged my expertise in ICD-10 coding and insurance verification at MedBill Management Inc. My proactive approach in denial management and patient collections, complemented by strong customer service support, significantly improved billing accuracy and patient satisfaction. Reliable Medical Biller with coding and medical terminology knowledge. Polished and hardworking performer with background overseeing accounts and handling records management tasks. Team-oriented person with great decision-making skills. Driven Medical Biller motivated to perform beyond expectations.
Overview
22
22
years of professional experience
Work History
Medical Biller
MedBill Management Inc
05.2023 - 02.2024
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Filed and updated patient information and medical records.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Collected payments and applied to patient accounts.
- Posted payments and collections on regular basis.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
- Liaised between patients, insurance companies, and billing office.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Delivered timely and accurate charge submissions.
- Collaborated with healthcare providers, ensuring accurate documentation for seamless billing operations.
- Acted as liaison between healthcare providers and insurance companies; resolved disputes quickly while maintaining positive relationships.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Supported efficient scheduling practices by verifying patient eligibility and coverage prior to appointments.
- Responded to customer concerns and questions on daily basis.
Office Medical Biller
Altais
02.2022 - 04.2023
- Reduced claim denials by accurately coding diagnoses, procedures, and treatments according to medical documentation.
- Collaborated with healthcare providers to obtain necessary medical records for accurate claim processing.
- Optimized workflow efficiency within the billing department by developing an organized filing system for invoices, reports, and correspondence.
- Increased patient satisfaction by effectively addressing billing inquiries and providing clear explanations of charges and payments.
- Minimized errors in data entry by implementing a thorough review process before submitting claims to reduce delays in payment processing.
- Expedited payment processing by accurately posting payments from insurance carriers and patients to respective accounts.
- Improved billing accuracy by thoroughly reviewing and updating patient information in the system.
- Maintained strong relationships with insurance carriers, addressing any discrepancies or issues promptly for faster resolution.
- Supported office staff during high-volume periods, coordinating tasks to ensure smooth management of daily operations.
- Safeguarded confidential patient information through strict adherence to HIPAA policies and regulations when handling sensitive documents and data entries.
- Collaborated with medical coders to ensure proper use of CPT, ICD-10, and HCPCS codes for accurate claim submission and compliance with industry standards.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility.
- Posted payments and collections on regular basis.
- Collected payments and applied to patient accounts.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Filed and updated patient information and medical records.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Liaised between patients, insurance companies, and billing office.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Delivered timely and accurate charge submissions.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Responded to customer concerns and questions on daily basis.
- Used data entry skills to accurately document and input statements.
- Handled account payments and provided information regarding outstanding balances.
- Collaborated with customers to resolve disputes.
- Monitored outstanding invoices and performed collections duties.
- Maintained accurate records of customer payments.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
Medical Biller
Brown And Toland Medical Group
01.2020 - 01.2022
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Filed and updated patient information and medical records.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Collected payments and applied to patient accounts.
- Posted payments and collections on regular basis.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
- Liaised between patients, insurance companies, and billing office.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Delivered timely and accurate charge submissions.
- Acted as liaison between healthcare providers and insurance companies; resolved disputes quickly while maintaining positive relationships.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Supported efficient scheduling practices by verifying patient eligibility and coverage prior to appointments.
- Improved patient satisfaction levels with clear explanations of their financial responsibilities and available payment options.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed outstanding balances owed by patients; initiated collection actions if necessary resulting in improved account recovery efforts.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Responded to customer concerns and questions on daily basis.
- Monitored outstanding invoices and performed collections duties.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
Office Medical Biller
Baywest Family Healthcare Inc
09.2001 - 12.2019
- Reduced claim denials by accurately coding diagnoses, procedures, and treatments according to medical documentation.
- Collaborated with healthcare providers to obtain necessary medical records for accurate claim processing.
- Optimized workflow efficiency within the billing department by developing an organized filing system for invoices, reports, and correspondence.
- Increased patient satisfaction by effectively addressing billing inquiries and providing clear explanations of charges and payments.
- Minimized errors in data entry by implementing a thorough review process before submitting claims to reduce delays in payment processing.
- Facilitated prompt reimbursements for healthcare providers through meticulous claim preparation and submission efforts.
- Managed accounts receivable aging report, identifying overdue balances for immediate follow-up actions towards timely debt recovery efforts.
- Expedited payment processing by accurately posting payments from insurance carriers and patients to respective accounts.
- Improved billing accuracy by thoroughly reviewing and updating patient information in the system.
- Maintained strong relationships with insurance carriers, addressing any discrepancies or issues promptly for faster resolution.
- Supported office staff during high-volume periods, coordinating tasks to ensure smooth management of daily operations.
- Negotiated favorable payment plans with patients experiencing financial difficulties while maintaining a compassionate and understanding approach.
- Enhanced revenue collection rates through diligent follow-up on unpaid claims and denied services.
- Streamlined the billing process with efficient invoice generation and timely submission to insurance companies.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility.
- Posted payments and collections on regular basis.
- Collected payments and applied to patient accounts.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Filed and updated patient information and medical records.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Liaised between patients, insurance companies, and billing office.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Delivered timely and accurate charge submissions.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Adhered to established standards to safeguard patients' health information.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Responded to customer concerns and questions on daily basis.
- Handled account payments and provided information regarding outstanding balances.
- Monitored outstanding invoices and performed collections duties.
- 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.
- Kept vendor files accurate and up-to-date to expedite payment processing.
Education
Certificate in Medical Assisting -
Bryman College
San Francisco, CA09.1995
High School Diploma -
Mission High School
San Francisco, CA06.1994
Skills
- Insurance Claims
- Insurance Billing
- Medical Billing
- Electronic Claims
- Insurance Verification
- HIPAA Compliance
- Customer Service
- Billing and Collection Procedures
- Patient Billing
- Insurance claims processing
- Medicaid and Medicare Knowledge
- Claim submission
- Data Entry
- Medicare and Medicaid process
- Denial Management
- CMS-1500 Billing Forms
- Claims Processing
- Payment posting
- ICD-10
- ICD-10 Proficiency
- Claims review
- Patient account analysis
- Medical claims submission
- Multitasking and Organization
- ICD-10 Coding
- Patient Collections
- Collections processing
- Payment Processing
- Customer service support
Languages
Spanish
Native or Bilingual
Timeline
Medical Biller
MedBill Management Inc
05.2023 - 02.2024
Office Medical Biller
Altais
02.2022 - 04.2023
Medical Biller
Brown And Toland Medical Group
01.2020 - 01.2022
Office Medical Biller
Baywest Family Healthcare Inc
09.2001 - 12.2019
Certificate in Medical Assisting -
Bryman College
High School Diploma -
Mission High School
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