Summary
Overview
Work History
Education
Skills
Timeline
Generic

Mayra Valdez

Lakewood,CA

Summary

Hardworking and passionate job seeker with strong organizational skills eager to secure a billing position. Ready to help team achieve company goals.

Overview

12
12
years of professional experience

Work History

Billing Specialist

Newgen
07.2023 - Current
  • Preparing, reviewing and transmitting electronic claims using our billing software and clearinghouse, and paper claims as necessary.
  • Ensure clean claims released and follow up on unreleased claims within billing cycle timeframes.
  • Review payments for accuracy and resolve claim issues based on the information provided in the EOB.
  • Coordinate with BOMs to investigate and resolve denied claims and return corrected claims to the appropriate insurer promptly.
  • Work with representatives of insurance companies to resolve payment discrepancies.
  • Possesses strong analytical, time management, organizational, problem solving and decision-making skills.
  • Follow up on unpaid claims
  • Post payments



Managed Care Billing Specialist

Rockport Healthcare Services
01.2020 - 06.2023
  • Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.
  • Completed appeals and filed and submitted claims.
  • Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
  • Performed quality control of data entry system to verify proper posting of claims and payments.
  • Reviewed and verified benefits and eligibility with speed and precision.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
  • Prepared and attached referrals, treatment plans or other required correspondence to reduce incidence of denials.

Billing Specialist

Retina Institute Of California
02.2013 - 12.2019
  • Verified insurance eligibility for patients by calling appropriate parties.
  • Sent meticulous and accurate bills to collect payment from customers according to company protocol.
  • Obtained prompt payments for open bills by interacting with appropriate parties.
  • Coded invoices properly based upon patient services and medical records.
  • Investigated and resolved issues to maintain billing accuracy.
  • Completed billing audits in identified timeframes to report and investigate findings.
  • Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.

Optometric Assistant/Biller

Dr. Li Optometry
07/01/18 - 12/15/22
  • Assisted with visual field testing, ocular photography, optical coherence tomography and pre-exam data collection.
  • Posted refractor receipts, entered data into spreadsheets and alphabetized folders and invoices.
  • Examined eyes, under observation, with instruments and pharmaceutical agents to determine visual acuity.
  • Answered phones, scheduled appointments, greeted patients and ordered supplies.
  • Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
  • Answered customer invoice questions and resolved issues discovered during invoicing and collection process.
  • Researched and resolved billing inconsistencies and errors through individual and collaborative analysis.
  • Managed numerous client accounts to track and collect money owed.

Medical Receptionist

Retina Institute
02/01/11 - 02/05/13
  • Checked patients in and out for appointments and collected co-payments.
  • Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
  • Managed office phone lines by checking voicemail, returning calls and directing messages to team members.
  • Carried out daily tasks by professionally communicating with physicians, nursing staff, technicians and medical assistants.
  • Called patients to confirm scheduled appointments and obtain additional details.
  • Entered insurance, demographics and health history into patient database.
  • Delivered high-quality administrative and customer service to sustain patient and work flows.
  • Protected patients by observing strict HIPAA guidelines.
  • Scheduled appointments, optimizing patient satisfaction, provider time and treatment room utilization.
  • Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
  • Communicated with insurance carrier, patient and third party or employer to verify patient insurance benefits.

Education

High School Diploma -

San Gabriel High School
San Gabriel, CA
07.2005

Skills

  • EMR Software
  • HIPAA Compliance
  • Verbal and Written Communication

Timeline

Billing Specialist

Newgen
07.2023 - Current

Managed Care Billing Specialist

Rockport Healthcare Services
01.2020 - 06.2023

Billing Specialist

Retina Institute Of California
02.2013 - 12.2019

Optometric Assistant/Biller

Dr. Li Optometry
07/01/18 - 12/15/22

Medical Receptionist

Retina Institute
02/01/11 - 02/05/13

High School Diploma -

San Gabriel High School

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Mayra Valdez