Summary
Overview
Work History
Education
Skills
Languages
Timeline
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MONICA OCHOA

KENNEWICK

Summary

Dynamic Medical Billing Manager with extensive experience at Richland Medical Group, excelling in claims processing and revenue cycle management. Proven track record in enhancing patient satisfaction and reducing denied claims through effective communication and staff training. Adept at navigating complex billing issues while ensuring HIPAA compliance and fostering team productivity.

Overview

9
9
years of professional experience

Work History

Medical Billing Manager

Richland Medical Group
01.2024 - Current
  • Reviewed billing problems, researched issues, and resolved concerns.
  • Worked with customers to develop payment plans and bring accounts current.
  • Increased patient satisfaction by addressing billing inquiries promptly and professionally.
  • Developed strong relationships with insurance companies through effective communication and negotiation skills, enhancing payment turnaround times.
  • Reduced denied claims through diligent review, correction, and resubmission of errors.
  • Managed a team of dedicated medical billers, focusing on professional development opportunities and maintaining a positive work environment conducive to high levels of productivity.
  • Enhanced revenue cycle management by overseeing timely and accurate claims submission.
  • Maintained up-to-date knowledge of regulatory changes impacting medical billing practices to ensure ongoing compliance within the organization.
  • Trained team members on best practices in medical billing, ensuring consistent high-quality work across the department.
  • Collaborated with providers and staff to ensure accurate coding for billing purposes.
  • Developed policies and procedures for the medical billing department, establishing a strong foundation that supported growth and operational success within the organization.
  • Optimized cash flow by regularly reviewing aging account balances and implementing tactics for timely collections from patients or insurers.
  • Monitored compliance with industry regulations to mitigate risks associated with audits and penalties.
  • Established internal audit procedures to validate and improve accuracy of financial reporting.
  • Accomplished multiple tasks within established timeframes.
  • Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.

Medical Billing Specialist

Richland Medical Group
06.2023 - 12.2023
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Posted and adjusted payments from insurance companies.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
  • Located errors and promptly refiled rejected claims.
  • Identified and resolved patient billing and payment issues.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
  • Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
  • Enhanced revenue collection through diligent follow-up on unpaid claims and denials with insurance companies.
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Collected payments and applied to patient accounts.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Precisely evaluated and verified benefits and eligibility.
  • Provided exceptional customer service to both patients and insurance representatives, resolving inquiries quickly and professionally.

Medical Biller, Accounts Receivable

Retina Laser Eye Center
11.2020 - 06.2023
  • Maintained confidentiality of patient information by adhering to strict HIPAA regulations throughout the billing process.
  • Provided exceptional customer service while addressing patient inquiries regarding billing issues or concerns.
  • Enhanced revenue by identifying and resolving billing discrepancies in patient accounts.
  • Established effective relationships with insurance company representatives to expedite claim processing times and increase reimbursement rates.
  • Assisted with staff training on updated medical coding systems, ensuring accuracy across all team members'' workloads.
  • Streamlined the billing process for increased efficiency by implementing new software solutions.
  • Ensured accurate coding and billing practices, resulting in reduced claim rejections and faster reimbursements.
  • Updated and maintained patient accounts within the billing system, ensuring accurate records for future invoicing and reimbursement processes.
  • Resolved complex billing issues involving multiple parties by effectively coordinating communication among healthcare providers, insurers, and patients.
  • Reduced account receivables aging through diligent follow-up on outstanding claims and prompt resolution of denials.
  • Posted payments and collections on regular basis.
  • Verified insurance of patients to determine eligibility.

AMBULATORY SURGERY CENTER BILLER

TRI-CITY ORTHOPAEDICS
07.2016 - 05.2020
  • Checked insurance eligibility by making appropriate phone calls and conducting research on services rendered.
  • Kept all patient information secure and confidential.
  • Executed billing tasks and recorded information in company databases.
  • Identified, researched, and resolved billing variances to maintain system accuracy and currency.
  • Determined proper codes for medical records and patient services.
  • Reduced billing errors by implementing strict policies and systematic procedures.
  • Enhanced team productivity by providing training on new billing software and processes.
  • Ensured compliance with relevant regulations and industry standards throughout all aspects of the billing process.
  • Managed a high volume of invoices, prioritizing workload to meet deadlines and maintain cash flow.
  • Streamlined the billing process by automating data entry tasks, leading to improved efficiency and accuracy.
  • Researched and resolved billing discrepancies to enable accurate billing.
  • Worked with multiple departments to check proper billing information.
  • Responded to customer concerns and questions on daily basis.
  • Maintained accurate records of customer payments.

Education

High School Diploma -

TOPPENISH HIGH SCHOOL
Toppenish, WA
06-1992

Skills

  • Claims processing proficiency
  • HIPAA compliance
  • Effective communication
  • Patient confidentiality practices
  • Electronic health records experience
  • Staff training and development
  • Accounts receivable management
  • Team leadership qualities
  • Medical coding expertise
  • Financial reporting
  • Revenue cycle management
  • CPT coding
  • Denial management strategies
  • Payment posting
  • Medicare and medicaid regulations

Languages

Spanish
Full Professional

Timeline

Medical Billing Manager

Richland Medical Group
01.2024 - Current

Medical Billing Specialist

Richland Medical Group
06.2023 - 12.2023

Medical Biller, Accounts Receivable

Retina Laser Eye Center
11.2020 - 06.2023

AMBULATORY SURGERY CENTER BILLER

TRI-CITY ORTHOPAEDICS
07.2016 - 05.2020

High School Diploma -

TOPPENISH HIGH SCHOOL

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MONICA OCHOA