Martha Alicia Lopez
Oxnard,CA
Summary
Detail-oriented Billing and Insurance Claims Specialist with a focus on processing claims and resolving discrepancies. Collaborates with clients and healthcare providers to achieve accurate and timely billing outcomes. Enhances relationships and streamlines operations through effective communication. Dedicated to optimizing billing processes and improving overall efficiency.
Overview
17
17
years of professional experience
Work History
Senior billing and Insurance Claims Specialist
Passages Malibu
Port Hueneme, California
04.2022 - 04.2026
- Processed and reviewed insurance claims for clients at Passages Malibu.
- Communicated with clients to gather necessary documentation for claims.
- Collaborated with healthcare providers to verify treatment details and billing accuracy.
- Maintained organized records of all claims and communications for easy access.
- Maintained detailed records of all claim activities including correspondence, decisions, payments.
- Supported efficient handling of complex claims and followed up on open, denied, or suspended claims to complete required line items.
- Collaborated with other departments to resolve customer inquiries regarding billing issues.
- Researched discrepancies on unpaid invoices and reconciled them.
Patient Account Representative
Vista Del Mar Hospital
Ventura, California
03.2022 - 04.2026
- Managed patient accounts and resolved billing inquiries effectively.
- Collaborated with medical staff to verify insurance information and eligibility.
- Assisted patients in understanding their financial responsibilities and options.
- Processed patient payments and maintained accurate financial records daily.
- Coordinated with collections agencies to manage outstanding patient balances.
- Educated patients on hospital policies regarding insurance claims and billing practices.
- Utilized electronic health record systems to update patient account information promptly.
- Trained new staff on processes related to patient account management efficiently.
- Analyzed claims denials from third party payers and identified potential solutions for reimbursement.
- Processed payments from patients and maintained accurate records of all transactions.
- Conducted follow-up calls with patients to ensure that accounts were up to date and properly documented.
- Ensured compliance with company policies concerning the privacy of confidential health information.
- Performed monthly reconciliations of patient accounts to ensure accuracy of financial data.
- Responded promptly to customer inquiries via telephone or email in a professional manner.
- Tar and chart preparation for medi- cal billing
Medical Billing and Collections Specialist
Vista del Mar Medical Grp
Oxnard, California
07.2015 - 12.2017
- Maintained 2500 active accounts.
- Managed patient accounts to ensure accuracy in billing and collections, enhancing financial stability.
- Communicated with patients about outstanding balances and payment plans, improving payment recovery rates.
- Verified patient insurance eligibility and coverage for medical services rendered.
- Followed up on unpaid or denied claims in a timely manner.
- Analyzed account receivables aging report to identify and address delinquent accounts, reducing collection delays.
- Processed credit card payments from patients for medical services rendered.
Medical Billing Clerk
Orion Rand Medical Billing
Simi Valley, California
10.2009 - 12.2012
- Verified patient insurance information, ensuring adherence to billing procedures and minimizing claim denials.
- Reconciled errors between patient accounts and third-party payers' records, ensuring accurate billing and timely payments.
- Investigated issues related to claim payments, resolving late or missing payments and correcting discrepancies with insurers.
Education
Medical Billing
Boston Reed College
Ventura, CASkills
- Claims processing
- Claims assessment
- Billing reconciliation
- Regulatory compliance
- Health records management
- Insurance background
- Customer management
- Time management
- Multitasking skills
- Team collaboration
- Attention to detail
Languages
Spanish
Professional
Timeline
Senior billing and Insurance Claims Specialist
Passages Malibu
04.2022 - 04.2026
Patient Account Representative
Vista Del Mar Hospital
03.2022 - 04.2026
Medical Billing and Collections Specialist
Vista del Mar Medical Grp
07.2015 - 12.2017
Medical Billing Clerk
Orion Rand Medical Billing
10.2009 - 12.2012
Medical Billing
Boston Reed College