MICHELE NAVARRO
Temecula,CA
Summary
Detail-oriented professional with excellent communication, interpersonal and creative thinking skills. Aiming to leverage my abilities to successfully fill the vacancy at your company. Frequently praised as hardworking by my peers, I can be relied upon to help your company achieve its goals.
Overview
10
10
years of professional experience
Work History
Medical Biller
Pacific Heart Medical Group
Murrieta, California
11.2024 - 07.2025
- Processed medical claims using electronic billing systems and software.
- Verified patient insurance information for accuracy and completeness.
- Communicated with healthcare providers to resolve billing discrepancies.
- Interpreted hospital face sheets received from the doctor and inputted, billed out via EMR.
- Processed medical claims and invoices for a high-volume healthcare facility, ensuring accuracy and adherence to billing guidelines.
- Managed accounts receivable by tracking outstanding payments, contacting patients for payment arrangements, and initiating collections when necessary.
Office Manager
Hera Counseling
Redlands, CA
06.2020 - 01.2022
- Prepared itemized statements, bills and invoices and record amounts due for items purchased and services rendered.
- Verfied accuracy of billing data and revised any errors.
- Supervised administrative staff and provided training and orientation to new staff.
- Learnt to operate new office technologies as were developed and implemented.
- Demonstrated ability to manage multiple tasks while remaining adaptable and flexible.
- Participated in ongoing training to enhance own job skills and knowledge.
- Perform completion of claims to payers
- Submit billing data to the appropriate insurance providers
- Achieve maximum reimbursement for services provided
- Resolve denial instances
Authorizations Lead
Pacific Dermatology
Redlands, California
04.2019 - 06.2019
- Maintaining email resource and internal log and working closely with directors • Interpreting doctors notes and requesting correct CPT codes as well as diagnosis
- Oversee a team of 5 Responsible for 4 office locations
- Sending out 80-100 authorizations a day
- Scheduling and rescheduling
- Prioritizing work to be sure done within deadline Point of contact for multiple offices and responding with correct information
- Working with various insurance portals to verify eligibility for patients
- Responsible for obtaining auth for prior and ongoing patients
- Insurance and patient aging
- Re-submit insurance claims as necessary
- Knowledgeable in timely filing restriction
Medical Collections Specialist
Ontrack Management
Riverside, CA
07.2016 - 01.2018
- Worked with Workers Compensation to make sure claims have been properly paid per WC fee schedule
- Reached out to worker compensation adjuster to receive accurate payment for services rendered
- Improved revenue for most recent provider over 32% with same patient load
- Experienced collections for Physical Therapy Ensure claims are entered and submitted within 48 hours of receipt
- Accurately apply payments to patient accounts
- Post and reconcile insurance and patient payments
- Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts
- Send secondary claims upon processing of primary insurance
- Answer and resolve patient billing inquires
Billing/Collections Specialist
Dr. Agarwal
Hemet, California
06.2016 - 11.2016
- Improved revenue for most recent provider over 32% with same patient load
- Experienced billing for Cardiology
- Ensure claims are entered and submitted within 48 hours of receipt
- Accurately apply payments to patient accounts Post and reconcile insurance and patient payments
- Research and resolve incorrect payments, EOB rejections, and other issues with outstanding accounts
- Ensure accuracy of insurance claims
- Verify correct ICD-10 and CPT codes for a variety of specialties up new patient accounts
- Assign ICD-10 to physician's diagnosis and ensure correct level of service and various other CPT codes
- Set-up practice management software for submission of electronic claims to clearinghouse
- Work with clearinghouse to resolve file compatibility issues
- Send secondary claims upon processing of primary insurance Monthly processing of patient statements
- Answer and resolve patient billing inquire
- Follow up on Insurance and patient aging Re- submit insurance claims as necessary.
Medical Biller
Cardiology Specialist Medical Group
Riverside, California
07.2015 - 06.2016
- Received hospital face sheets from doctor, coded and billed
- Verified PT insurances thru web portals and over phone High velocity of phones
- Follow up on sent out claims and rebill denial claims
- Work on account receivables
- Verified Pt is active with Insurance and collected Co-payments and made sure deductibles were current
- Use program EMR and Practice Management on a daily basis
- Insurance Billing Blue Cross Blue Shield Medicare Champus IEHP
- Champ VA Workers Comp Medicaid HMO/PPO
Education
Diploma - Medical Administrative Assistant
Concorde Career College
Redlands, CA07.2015
Medical Assistant -
ROP Redlands Yucaipa
Redlands, CA07.2009
High School Diploma -
Green Valley HIgh
Yucaipa, CA06.2008
Skills
- Medical insurance expertise
- Claims processing
- Interpersonal communication
- Office management
- Medical billing and collections
- Medical terminology proficiency
- Insurance portal navigation
- CPT coding
- Practice management software
- Online claim submission
- Electronic remittance advice (ERA)
- Data entry accuracy
- Customer service excellence
- Microsoft Office proficiency
- Appointment scheduling
- Insurance verification processes
- EMR systems knowledge
- Medical office operations
- Medical collections management
- ICD-10 coding expertise
- Claim entry accuracy
- Payment posting procedures
- MediSoft software proficiency
- Medical records organization
Timeline
Medical Biller
Pacific Heart Medical Group
11.2024 - 07.2025
Office Manager
Hera Counseling
06.2020 - 01.2022
Authorizations Lead
Pacific Dermatology
04.2019 - 06.2019
Medical Collections Specialist
Ontrack Management
07.2016 - 01.2018
Billing/Collections Specialist
Dr. Agarwal
06.2016 - 11.2016
Medical Biller
Cardiology Specialist Medical Group
07.2015 - 06.2016
Diploma - Medical Administrative Assistant
Concorde Career College
Medical Assistant -
ROP Redlands Yucaipa
High School Diploma -
Green Valley HIgh
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