Overview
Work History
Education
Skills
Timeline
Generic

Melinda Lara

Colton ,CA

Overview

4
4
years of professional experience

Work History

Front Office Supervisor

Healthpointe Medical Group
Colton, CA
08.2020 - Current
  • Supervised front office staff, including hiring and training new employees.
  • Ensured proper customer service standards were met.
  • Monitored guest check-in and check-out procedures.
  • Handled customer complaints in a professional manner.
  • Maintained accurate records of all guests' bookings and payments.

Lead Referral Coordinator

Healthpointe Medical Group
Colton, CA
08.2022 - 12.2023
  • Developed and maintained relationships with referral sources to ensure a successful referral process.
  • Created and implemented a system for tracking referrals, follow-ups, and outcomes.
  • Coordinated communication between primary care physicians, specialists, and other healthcare providers regarding patient referrals.
  • Provided training to staff on the referral process and how to use the electronic health records system.
  • Assisted in developing policies and procedures related to the referral process.
  • Conducted regular meetings with primary care physicians to discuss strategies for improving the referral process.
  • Worked closely with insurance companies to ensure that patients received appropriate coverage for their referrals.
  • Monitored patient progress during their course of treatment from referral source through completion of services.
  • Performed data entry into various databases related to referrals, including demographic information, medical history, insurance information.
  • Maintained accurate records on all referrals completed by the organization.
  • Analyzed reports generated from the database to identify areas of improvement within the referral process.
  • Facilitated communication between internal departments regarding new or updated referrals.
  • Researched potential new referral sources as needed.
  • Ensured compliance with all applicable regulations regarding patient referrals.
  • Prepared detailed documentation for each patient's visit related to their referral.
  • Collaborated with clinical staff members on any changes or updates needed in relation to active referrals.
  • Provided feedback and recommendations on ways to improve efficiency within the referral process.
  • Acted as a liaison between external organizations and internal departments when necessary.
  • Advised patients on their rights and options concerning their referred treatments or services.
  • Assessed incoming requests for authorization of services prior to processing them appropriately.
  • Responded promptly and professionally to inquiries from referring physicians or agencies concerning patient cases or services provided.
  • Scheduled patients according to availability, urgency and insurance authorization guidelines.
  • Reviewed demographic, clinical and insurance information before sending to referred specialists.
  • Answered questions and resolved concerns raised by both patients and specialists.
  • Prioritized referrals according to urgency and adhered to appropriate referral deadlines.
  • Reviewed referral details and expectations with providers and patients and requested new referrals when necessary.
  • Managed daily patient referrals daily through multi-line telephone system.
  • Reviewed data obtained from referring physicians for completeness and accuracy.
  • Performed additional office duties, handling patient service inquiries and receiving payments.
  • Assisted referred patients in filling out applications and insurance forms.
  • Verified documents and associated records to catch and resolve discrepancies.
  • Developed productive working relationships with numerous insurance company representatives.
  • Collected and analyzed referral data and tallied number of referrals.

Medical Biller and Coder

Riverside Cardiology Associates
Riverside, CA
01.2022 - 08.2022
  • Reviewed medical records and identified diagnosis codes, procedures, services and supplies for coding.
  • Verified accuracy of patient information and insurance data in billing system.
  • Submitted claims to insurance companies electronically or by mail.
  • Resolved denied claims by researching payer requirements and preparing appeals.
  • Reconciled accounts receivable to ensure accuracy of payments received.
  • Maintained up-to-date knowledge of coding regulations and changes in reimbursement policies.
  • Performed daily audits on all bills submitted for accuracy and completeness.
  • Analyzed patient accounts for errors, inaccuracies or discrepancies in billing documentation.
  • Assisted with the development of departmental policies related to charge capture processes and coding practices.
  • Provided customer service support to patients regarding billing inquiries.
  • Processed corrections and adjustments as needed to ensure accurate payment from third party payers.
  • Developed an understanding of how various insurance plans process claims for reimbursement purposes.
  • Worked closely with physicians to obtain additional clinical information when needed for accurate coding assignments.
  • Maintained current CPT, HCPCS codes library as well as ICD-9, 10 CM diagnostic codes.
  • Prepared financial statements that summarize account activity over a period of time.
  • Ensured timely filing of all claims within established guidelines.
  • Monitored aging accounts receivable report weekly to identify unpaid balances due.
  • Identified trends in denials and worked collaboratively with clinic staff to reduce denials.
  • Responded promptly to requests from insurance companies regarding clarification on claim submissions.
  • Filed and submitted insurance claims.
  • Reviewed received payments for accuracy and applied to intended patient accounts.
  • Documented and filed patient data and medical records.
  • Assessed medical codes on patient records for accuracy.
  • Performed routine quality assurance audits to promote data integrity.
  • Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
  • Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
  • Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.

PRE Medical Biller and Coder

Healthpointe Medical Group
Colton, CA
08.2020 - 12.2020
  • Gave accurate information regarding billing and payment options.
  • Analyzed changes in policies, procedures, regulations affecting billing operations.
  • Resolved discrepancies between billing codes and clinical documentation.
  • Generated monthly billing adjustments and entered details into billing system to resolve discrepancies.
  • Resolved billing inquiries and refunded incorrect charges.
  • Reviewed and processed utility billing invoices for accuracy.

Education

Some College (No Degree) -

UEI College
Riverside, CA

Skills

  • Scheduling and calendar management
  • Employee Management
  • Oral and writing communication
  • Revenue optimization
  • Conflict Mediation
  • Staff Training and Development
  • Front Desk Operations
  • Emergency Procedures

Timeline

Lead Referral Coordinator

Healthpointe Medical Group
08.2022 - 12.2023

Medical Biller and Coder

Riverside Cardiology Associates
01.2022 - 08.2022

Front Office Supervisor

Healthpointe Medical Group
08.2020 - Current

PRE Medical Biller and Coder

Healthpointe Medical Group
08.2020 - 12.2020

Some College (No Degree) -

UEI College

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Melinda Lara