Monique Jimenez
Oceanside,Ca
Summary
I'm a certified medical biller. I am well organized, detail-oriented, good at prioritizing workload and time management. I have a clear understanding of patient insurance verification & coverage. I am a reliable, hard worker, with great multi-tasking skills. I have the ability to prioritize tasks to ensure billing/resolution of claims are done accurately. Within my 10 years at a fast-paced, multi-specialty medical setting, I've gained my experience to properly obtain the different types of payer information and data entry into accounting in Epic software. Knowledge submitting the proper documents records to support medical necessity based on diagnosis and services rendered. Trained in ICD-10, knowledge of CMS 1500 rules, and HCPCS coding principles. I have knowledge in reading medical records using medical terminology, MS Office products.
Overview
12
12
years of professional experience
Work History
Patient Biller
UCSD Helath
09.2024 - Current
- Experience using Epic and payor portals for checking eligibility, claim status and appeal submissions.
- Kept all patient information secure and confidential.
- Improved revenue cycle management by identifying trends and making strategic recommendations for optimization.
- Medicare/Medicare Managed Care experience with processing and resolving claims within a medical billing environment.
- submitted medical records in order to support medical necessity based on diagnosis and services rendered.
- Checked the verification of insurance coverage and adjudication via a payer portal, Epic system or by phone.
- Assisted in the filling of work. comp claims and the medical records needed.
Front Desk Scheduling Coordinator
UCSD Cancer Center
06.2016 - 09.2024
- Gathered authorization, registered patients and verified insurance eligibility.
- Precisely completed appropriate paperwork, documentation and system entry.
- Experience with creating referral shells for initial consultation.
- Assisted in the submitting proper documentation to insurance for denial's.
- Knowledge in insurance claims appeals, and range of knowledge in ICD-10, CPT, and HCPCS coding principles.
- Entered information into the Epic EMR & Cadence system efficiently and without errors.
- Verified patient coverage/insurance for consults and appointments
- Maintained strict patient and physician confidentiality. HIPPA compliance
- Interacted with providers and other medical professionals regarding medical records pertaining to medical necessity based on diagnosis and scheduling in a timely manner.
- Understanding of state and federal rules for billing and appealing medical claims.
- Scanning imaging into patients chart for doctor to review.
- Proficiency with MS Office Products (Mail, Excel and Word)
Scheduling Coordinator
Medical Group of North County
06.2013 - 06.2016
- Scheduled appointments, registered patients and verified insurances.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Professionally and courteously verified appointment times with patients.
- Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op Reports, and forms).
- Adeptly managed a multi-line phone system and pleasantly greeted all patients.
- Verified patients' eligibility and claims status with insurance agencies.
- Entered information into the Epic EMR system efficiently and without errors.
- Prepared patient charts accurately and neatly for the clinic.
- Prepared patient charts, pre-admissions and consent forms as necessary.
- Maintained strict patient and physician confidentiality.
- Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.
Education
High School Diploma -
Vista High School
Vista, CA01.2005
Billing / Coding Degree - Medical
Kaplan College
Vista, CA01.2013
Medical Billing Certification - Revenue Cycle
Vista Adult School
Vista, Ca 06-2024
Skills
- Proficient in Epic software
- Detail-oriented, organized
- Extensive knowledge in Insurance claims & appeals
- HIPAA compliance
- Knowledge using ICD-10,CPT coding, CMS 1500 claims
- Medical Terminology
- Resourceful and reliable worker
- Proficient MS Office Products
- Capable of verifying patient coverage/insurances
- Familiar with reading medical records & submitting claims
- Experience in authorizations & referrals
Timeline
Patient Biller
UCSD Helath
09.2024 - Current
Front Desk Scheduling Coordinator
UCSD Cancer Center
06.2016 - 09.2024
Scheduling Coordinator
Medical Group of North County
06.2013 - 06.2016
Billing / Coding Degree - Medical
Kaplan College
High School Diploma -
Vista High School
Medical Billing Certification - Revenue Cycle
Vista Adult School
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