Melissa Frausto
Richter Healthcare Consultants
Lubbock,Tx
1
Certification
9
years of professional experience
To establish a career utilizing my skills and experience along with earning the opportunity for growth.
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Work History
Medicaid Billing Specialist
3 Months- Managed Residence Medicaid and Billing accounts.
- Reviewed, corrected, and submitted insurance claims for accurate reimbursement in Waystar and Point Click Care.
- Investigated aging accounts and developed payment recovery plans.
- Assisted in month end close for triple check.
- Communicate claim status and project updates with clients and management.
- Performed patient account analysis and insurance follow-up.
- Generated clean claims while maintaining billing compliance.
- Documented billing activities in electronic medical records and billing systems.
- Collaborated with clients and team members to resolve billing issues efficiently.
- Hospice billing, Remits, Denials, Aging
- Verified patient demographics and insurance eligibility.
- Submitted Medicare, Medicaid, Hospice Claims.
- Verified Benefits using Availity, Waystar, Massachusetts Portal, United Healthcare Portal.
- Obtained and documented prior authorizations.
- Monitored claim status and resolved billing issues.
- Maintain accurate patient records within Point Click Care.
- Ensured claims were submitted accurately and in a timely manner.
Business Office Manager
1 Year 1 Month- Processed all LTC Medicaid Applications / LTC Medicaid Recertifications from start to finish.
- Reached out to family members to gather information along with paperwork needed.
- Filled out all paperwork for Rep Payee / all forms for Medicaid Applications.
- Social Security Disability Paperwork.
- Social Security Change Forms.
- 72-hour meet and greet and notification of financial responsibility.
- Potential Medicaid Screening – QMB & LTC MCD.
- Patient Liability.
- Collect co-pays /Private Pays.
- Assisted with end of the month closing for triple check.
- RFMS Patient Trust Fund.
- Refund Checks.
- Billing Part A & Part B for Physical Therapy.
- Vendor Tab.
- Residence Tab.
- Over Assets.
- Over Drafted Accounts.
- Missing Applications.
- Medicaid Billing/Aging Review.
- Hospice Billing / Write offs.
- Generated Statements end of month.
- All Private Pays.
- Authorizations / Patients Demographics.
- Insurance Referrals.
- Ran all Insurance Eligibility / Verification of Medicaid & Medicare.
- Posted Payments /Discussed Billing Questions with Patients and Family Member’s.
- Set up auto pay through Rev Springs.
- Manager – Laurie Westbrook 806-773-4343
Medical Billing Specialist
2 Years 1 Month- Worked Factsheets, entered all demographic information, verified correct insurance filing information on patients face sheets, uploaded to patient’s charts, check claims status on appropriate payor system find the correct payor upload insurance claims and submit to the insurances.
- Call prior authorization if needed for the claim and enter them into e-clinical system.
- Verify Insurance from different states using cortex, availity, palmetto, waystar and any resources needed.
- Also verified Medicare and Medicaid insurance Claims along with VA and workman’s comp.
- Bill out for 5 providers, Fill out HCFA Forms, Patient responsibility and Denials.
- Worked in EMR system.
- Manager – Jennifer Johns 817-353-6494
Medical Receptionist / Front Desk
4 Months- Greeted and served patients, in person and over the phone, in a professional friendly respectful manner.
- Navigate /utilize multiple providers schedule and systems efficiently.
- Verified Insurance Eligibility, collected copays and owed balances checked patients in and out, answered multiple phone lines.
- Returned voicemails, making appointments, preparing super bills for the next day, updated medical forms along with addresses.
- Scan in insurance cards, prepared deposit at the end of the day.
- Sent out new patient paperwork.
- Check emails, faxes, medical release forms, and medical records.
- Take payments on account.
- Manager Ruby 806-799-4192
Medical Receptionist and Medical Assistant Office Manager
2 Years 3 Months- Checked patients in& out, answered multi-phone lines, Verify Co-Insurance and eligibility, Setup Surgery schedule for outpatient surgeries, Pré-Authorization, CPT, ICD Coding, Pre-Certifications, took payments over the phone, registered new patients, pulled charts for the next day, filed charts, daily reports & deposits at the end of the day.
- Called patients to verify appointments, called patients to set up surgery dates& times with instructions followed, made copies of insurance cards & ID Cards , ordered office supplies & medical supplies, called patients back, called in prescription to pharmacy, prepared patients, filled all history paperwork out with patient, cleaned patients room, set up procedure rooms for surgery stocked all medical exam rooms, took X-Rays, Developed X-Rays, Collecting & Billing, Filled out all of FMLA Paperwork.
Education
Skills
Medicaid Billing
Medicare Billing
Hospice Billing
Medical Claims Processing
Accounts Receivable
Denial Management
UB04 Forms
Insurance Verification
Skilled nursing facility experience
Long Term Care facility experience
Payment posting in medical billing systems
HIPPA
Medical Terminology
Organization Skills
Prior Authorizations
Electronic Medical Records (EMR)
Microsoft Office
Customer Service
Problem Solving
Point Click Care
e-Clinical works
Next Gen
Waystar
Availity
Palmetto
Massachusetts Portal
United Health Care
Data Entry
Medical Office Experience
Customer Inquiry handling
Attention to detail
Management Experience
Long Term Care Medicaid Applications
Medicaid Re-Certifications.
Certification
- Phlebotomy Certificate
- Nail Technician License
Languages
Spanish – Write and Speak Fluently
Timeline
Medicaid Billing Specialist
Richter Healthcare Consultants
03.2026 - 06.2026Read More
Business Office Manager
Garrison Center / Nursing Home Facility& Skilled
01.2025 - 02.2026Read More
Medical Billing Specialist
MD Billing Specialist
12.2022 - 01.2025Read More
Medical Receptionist / Front Desk
Allergy & Asthma Clinic of West Texas
06.2022 - 10.2022Read More
Medical Receptionist and Medical Assistant Office Manager
South Plains Center for Foot Care
04.2017 - 07.2019Read More
Amarillo College of Hairdressing
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Amarillo College
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Kress High School
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