Moises Ortuno
Houston,TX
Summary
Customer service professional with 11 years working in the Revenue Cycle Healthcare Industry. Proficient in Spanish (Fluent-Verbal and Written) with strong analytical, problem-solving and communication skills.
Overview
11
11
years of professional experience
Work History
Revenue Cycle Specialist
Planned Parenthood Gulf Coast
05.2014 - Current
- Responsible for audit of daily charges and adjustments of patient accounts while interacting with Health Center Managers and Patient Care administrators. Ensure follow up is taken on coding errors or concerns, uplift and help resolve revenue cycle issues and serve as liaison between Planned Parenthood Gulf Coast (PPGC) and Clinical Health Network (CHN).
- Support follow up of clinical audit and coding reviews to ensure all documentation is accurate and precise. Review patient adjustments (CF and Prompt Pay) for accuracy.
- Ensure all payment postings are complete, accurate and within deadlines. Review and process any insurance and patient refunds.
- Verify insurance eligibility, benefits and prepare patient estimated copays. Review daily workqueue’s that include registration, claim edits, chart review and claim rejections.
- Assist with annual year-end audit preparation as requested. Data gathering and reporting capabilities of our current and legacy systems in order to efficiently problem-solve by generating reports and extracting data.
Education
Billing and Coding
Remington College
Houston, TX05.2014
High school - undefined
Milby High School
05.2010
Skills
- Claims Review
- Epic Professional Billing
- Credit Balance Resolution
- Refund Analyst
- Account Reconciliation
- EOB Interpretation
- Insurance Collaboration/Verification
- Payment Collection
- Project Management
- Proficient with EPIC, ECW & Cintricity
Languages
Spanish
Native or Bilingual
Timeline
Revenue Cycle Specialist
Planned Parenthood Gulf Coast
05.2014 - Current
Billing and Coding
Remington College
High school - undefined
Milby High School