Myreena Moreno
Fontana,CA
Summary
To secure a position with a well-established organization with advancement opportunities utilizing my skills in the medical field.
Overview
21
21
years of professional experience
Work History
IHSS Caretaker
Chino, CA
02.2023 - 02.2024
- Perform basic day-to-day activities
- Assisting with personal care, such as bathing and getting dressed
- Administering medication
- Providing companionship
- Assisting with ambulation and mobility around the house or outside
- Helping with physical therapy exercises
- Shopping, Planning, and preparing meals
- Scheduling and assist with all and any doctor appointments.
Senior Govt Payer Biller
Prime Healthcare
Ontario, CA
02.2021 - 02.2023
- Specialized working aged accounts for underpayments, no authorization, timely filing and determine the DOFR for every claim
- Working experience with all payer types including commercial, governmental, Medicare, Medicaid, HMO and the ability to cross-over into different payers
- Communicates clearly and efficiently by phone with health plans
- Knowledge of contract interpretation
- Submit appeals for provider disputes, reconsideration, retro authorizations underpayments, timely filing, and medical necessity
- Submit all documents internal and external for denied claims
- Once appeals have been exhausted submit to Maximums with all documentation for review on denied appeals made by healthplan
- Price all claims according to contract rates and submit write-offs to reflect the correct allowed amount
- Price claims with CMS pricer if needed
- Work secondary claims and submit to payers or patient with the primary EOB
- Accountable and responsible for billing through account closure.
Patient Acct Rep
PIH Health
Whittier, CA
02.2018 - 02.2021
- Submit claims for outpatient/inpatient rehab therapy, transitional living day treatment, wound care clinic, radiation, chemotherapy, and hyperbaric treatment billing
- Bill and resubmit corrected claims through Cirius
- Ensure claims were submitted to the correct payer (Commercial, HMO, PPO, EPO and Worker Comp)
- Attached appropriate supporting documentation for bills
- Bill all secondary/crossover claims to the correct payers with the primary EOB attached
- Verify insurance information, update patient demographics and insurance payers and other basic billing information as requested through MS4 and Cerner
- Ensure that all claims are made within the internal time frames with each payer
- Ensure the correct DOFR for all services rendered at PIH.
Medical Biller/Collector
Casa Colina Hospital
Pomona, CA
02.2014 - 02.2018
- Worked aged and new accounts for outpatient/inpatient rehab therapy, transitional living day treatment, wound care clinics and hyperbaric treatment for all of Casa Colina Hospital
- Bill and resubmit corrected claims through DSG and Jopari with attached documents
- Ensure claims were submitted to the correct payer (Commercial, HMO, PPO, EPO and Worker Comp)
- Attached appropriate supporting documentation for bills
- Bill all secondary/crossover claims to the correct payers with the primary EOB attached
- Submit Appeal, Reconsideration and retro-auths for any and all denied claims or underpaid claims not paid per our contract rate
- Provider support to customer service representatives for resolution of external inquire
- Verify insurance information, update patient demographics and insurance payers and other basic billing information as requested
- Ensure that all claims, reconsiderations, appeals, retro-auth is made within the internal time frames with each payer.
Aged Claims Rep/Medical Biller
Financial Healthcare
Pasadena, CA
05.2013 - 02.2014
- Worked aged accounts for Torrance Memorial Hospital
- Bill and Rebill facility and professional claims to insurance carriers for appropriate payments (Commercial, HMO, PPO and EPO’s)
- Provide support to Customer Service Representatives for resolution of external inquiries
- Follow up on facility and professional claims for emergency, inpatient, and outpatient services
- Verify insurance information or other basic billing information as requested
- Attach appropriate supporting documentation to bills
- Obtain missing data and correct inaccurate insurance/demographic information
- Ensure that submittals are made within internal time frames as well as payer stature.
Medical Biller
Jong G. Kim MD., Inc
West Covina, CA
01.2003 - 05.2013
- Insurance verification of all insurance types
- Electronic claim submission for Commercial, HMO, EPO and PPO, Medicare, Medi-cal and Medi-Medi claims
- Post accounts receivable and payable, collections, bookkeeping, file claim appeals, submit TAR authorizations, submit pre-authorization for surgeries and deliveries.
Education
Cal Poly Pomona-Medical Coding Course
Northwest College-Medical Biller Certified
Chino High School-General studies
GED Certificate
Skills
- Patient assistance
- Attention to Detail
- Medical Billing
- File coordination
- Insurance Verification
- Coding
- Medical terminology knowledge
- Insurance Billing
- Collections experience
- Follow-up skills
- Medical Terminology
- Dispute Resolution
- Insurance billing procedures
- Patient information management
- Commercial and Private Insurance
- Patient Billing
- CPT code modifiers
Timeline
IHSS Caretaker
02.2023 - 02.2024
Senior Govt Payer Biller
Prime Healthcare
02.2021 - 02.2023
Patient Acct Rep
PIH Health
02.2018 - 02.2021
Medical Biller/Collector
Casa Colina Hospital
02.2014 - 02.2018
Aged Claims Rep/Medical Biller
Financial Healthcare
05.2013 - 02.2014
Medical Biller
Jong G. Kim MD., Inc
01.2003 - 05.2013
Cal Poly Pomona-Medical Coding Course
Northwest College-Medical Biller Certified
Chino High School-General studies
GED Certificate