Michelle Loya

• Completed and submitted appeals for denied claims.
• Communicated with insurance representatives to complete claims processing or resolve problem claims.
• Submitted appeals using provider portals and phone communication.
• Contacted insurance providers to verify insurance information and obtain billing authorization.
• Coordinated communications between patients, billing personnel and insurance carriers.
• Reviewed claims for coding accuracy.
• Monitored reimbursement from managed care networks and insurance carriers to verify consistency with contract rates.
• Handled billing, waivers and claims for private and commercial clients.
• Input details into accounts and tracked payments.
• Distributed or posted financial data to appropriate accounts and prepare simple reconciliations.
• Leveraged EMR software to post payments received for medical services.
• Organized information for past-due accounts and transferred to collection agency.
• Maintained billing software by updating rate change, cash spreadsheets and current collection reports.
• Interpreted medical terminology and pharmacological information to translate information into coding system.
• Submitted claims to insurance companies.
• Managed all payments processing, invoicing and collections tasks.
• Monitored past due accounts and pursued collections on outstanding invoices.
• Collected, posted and managed patient account payments.
• Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
• Performed insurance verification, pre-certification and pre-authorization.
• Checked claims coding for accuracy with ICD-10 standards.
• Input statement information, reconciled accounts and resolved discrepancies.
• Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
• Assessed billing statements for correct diagnostic codes and identified problems with coding.
• Was responsible for every aspect, from contracts, coding, posting payments, follow up with insurance companies and patient accounts.

Elevated customer satisfaction ratings by promptly resolving client and case issues.

• Maintained confidentiality on all patient record data.
• Obtained prompt payments for open bills by interacting with appropriate parties.
• Sent meticulous and accurate bills to collect payment from customers according to company protocol.
• Verified insurance eligibility for patients by calling appropriate parties.
• Coded invoices properly based upon patient services and medical records.
• Investigated and resolved issues to maintain billing accuracy.
• Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.