Melissa Duran
Dallas,TX
Summary
Dynamic Medical Biller with extensive experience at Lankford Hand Surgery, adept at processing insurance claims and resolving billing discrepancies. Proven track record in enhancing billing accuracy and compliance, while delivering exceptional customer service. Skilled in ICD-10 and claims processing, contributing to timely reimbursements and improved financial outcomes.
Overview
13
13
years of professional experience
Work History
Medical Billing Specialist
Caresource Inc
03.2021 - Current
- Conducted comprehensive insurance verifications for patient accounts to ensure accurate billing and coverage.
- Processed authorization requests efficiently, ensuring compliance with regulations and organizational policies.
- Coordinated with healthcare providers to verify patient eligibility and coverage details.
- Processed insurance claims accurately to ensure timely reimbursement for services rendered.
- Verified accuracy of accounts payable payments, resulting in [Number]% reduction in payment errors and check reissues.
Senior Billing Specialist
Lankford Hand Surgery
05.2013 - 01.2020
- Processed daily billing transactions with accuracy and attention to detail.
- Resolved customer inquiries regarding billing discrepancies effectively.
- Maintained organized records of invoices and payment histories.
- Collaborated with cross-functional teams to ensure timely bill resolution.
- Assisted in implementing new procedures for improved billing accuracy.
- Conducted regular audits of accounts receivable to identify discrepancies.
- Trained new team members on billing systems and best practices.
- Worked with multiple departments to check proper billing information.
- Reduced errors in financial records by conducting regular audits of billed accounts.
- Maintained up-to-date knowledge of billing regulations and compliance requirements, ensuring adherence to legal standards.
- Managed monthly billing cycles to ensure timely issuance of invoices and statements.
- Handled account payments and provided information regarding outstanding balances.
- Processed payment via telephone and in person with focus on accuracy and efficiency.
- Audited and corrected billing and posting documents for accuracy.
- Generated monthly billing and posting reports for management review.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Processed insurance claims efficiently, reducing turnaround time for reimbursements.
- Developed a comprehensive understanding of ICD-10-CM, CPT, and HCPCS codes to ensure proper use in medical coding assignments.
- Reduced errors in medical billings, effectively addressing discrepancies and rectifying issues promptly.
- Established positive relationships with insurance companies, facilitating open communication lines for efficient claim processing.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Generated reports to identify coding trends and discrepancies.
- Managed complex billing processes, ensuring timely and accurate invoicing for surgical services.
- Posted payments and collections on regular basis.
- Collected payments and applied to patient accounts.
Medical Front Office Receptionist
Orthopedic Center of Mesquite
04.2012 - 05.2013
- Managed patient scheduling and appointment confirmations to enhance clinic efficiency.
- Greeted patients and assisted with check-in processes, ensuring a welcoming environment.
- Handled insurance verification and pre-authorization procedures for seamless patient care.
- Maintained accurate electronic health records utilizing practice management software.
- Processed patient payments and managed billing inquiries promptly and accurately.
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Maintained a clean and welcoming reception area to ensure a positive first impression for all visitors to the medical facility.
- Helped patients complete necessary medical forms and documentation.
- Verified and updated demographic and other personal information for clients with respect to personal boundaries when asking for important details.
- Managed multi-line phone system and pleasantly greeted patients.
- Completed clerical duties and tasks for clinic administration.
- Checked patient insurance, demographic, and health history to keep information current.
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Kept waiting room neat and organized by stacking magazines, removing trash, and cleaning glass.
- Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
- Answered phone calls
- Maintained current and accurate medical records for patients.
- Processed insurance verifications and pre-authorizations, ensuring compliance with policies.
Education
High School Diploma -
Hillcrest High School
Dallas, TX06-1997
Skills
- Insurance billing
- Medical billing
- Electronic claims
- Billing and collection procedures
- CPT knowledge
- Insurance claims processing
- Claim submission
- Denial management
- Claims processing
- Payment posting
- ICD-10
- Electronic health record software
- Claims review
- Patient account analysis
- Medical claims submission
- Collection calls
- Patient collections
- Disability claims process
- Medical coding
- Balance reconciliation
- CPT code modifiers
- Reimbursements
- Submission of medical claims
- Account follow-up
- Insurance collections
- Payment processing
- Billing statement review
Timeline
Medical Billing Specialist
Caresource Inc
03.2021 - Current
Senior Billing Specialist
Lankford Hand Surgery
05.2013 - 01.2020
Medical Front Office Receptionist
Orthopedic Center of Mesquite
04.2012 - 05.2013
High School Diploma -
Hillcrest High School
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