Nathalie Ojeda
UT
Summary
Experienced Billing Specialist with 13 years in healthcare billing, reimbursement review, and account auditing. Expertise in identifying discrepancies and ensuring accurate documentation to enhance workflow efficiency. Knowledgeable in Microsoft Excel, QuickBooks, and data management systems, with strong analytical and organizational abilities.
Overview
13
13
years of professional experience
Work History
Billing Specialist
Myriad Genetics
05.2019 - Current
- Process billing operations and account reviews within a high-volume healthcare environment.
- Review claims, billing records, and documentation to identify and correct discrepancies.
- Validate EOB with insurance companies
- Executed backend billing support, ensuring accuracy in account reconciliation records.
- Coordinated with internal departments to enhance billing workflows and ensure timely processing.
- Maintain detailed documentation while following HIPAA and company compliance standards.
- Conducted audits of billing information for accuracy before final processing and monthly close activities.
- Utilize internal systems, Microsoft Excel, and reporting tools to support billing operations and data accuracy.
HR & Accounting Coordinator (Part-Time)
Excell Steel Buildings
08.2021 - 02.2024
- Managed payroll processing, employee records, and HR administrative functions to ensure compliance and accuracy for steel building company.
- Maintained bookkeeping records and accounting documentation, ensuring accurate financial data entry to support business operations.
- Assisted with accounts payable, invoicing, and payroll reconciliation.
- Coordinated onboarding paperwork and organized employee documentation to streamline new hire integration.
- Utilized Microsoft Excel and accounting systems to track financial records and company operations.
- Supported day-to-day office operations while maintaining confidentiality and accuracy in employee and financial records.
Payment Posting Specialist
R1 Rcm
01.2018 - 05.2019
- Processed high volumes of payments accurately and efficiently to ensure timely posting.
- Reviewed payment discrepancies, resolving issues to maintain accurate financial records.
- Collaborated with cross-functional teams to streamline payment posting processes and enhance efficiency.
- Handled claims processing for reversals and adjustments, maintaining high standards of accuracy. Conducted claims recovery by preparing refund request letters and issuing refund checks. Facilitated claim reversals to correct discrepancies and uphold client satisfaction.
- Oversaw exception and error listing for hospital receivables, addressing overpayments and refunds. Guaranteed daily posting of payments aligned with end-of-day financial summaries. Handled unapplied and misapplied payments to ensure precise accounting records. Reviewed transactions after posting to mitigate errors and enhance accuracy.
Health Data Analyst
R1 Rcm
06.2017 - 01.2018
- Analyzed health data trends to identify areas for process improvement and operational efficiency.
- Implemented data quality checks, increasing reliability of healthcare analytics outputs.
- Optimized data storage solutions, reducing system downtime and increasing accessibility for medical staff.
- Access patient charts from various hospital departments
- Coordinated and recorded patient details in system
Broker Reimbursement Specialist
Molina Healthcare
02.2013 - 05.2017
- Processed broker reimbursement requests by reviewing records, verifying eligibility, and confirming payment history to ensure timely reimbursements.
- Issued refund checks and confirmed accuracy through detailed report verification.
- Reconciled account balances by investigating discrepancies and submitting corrections for underpayments and overpayments, enhancing financial accuracy.
- Collaborated with billing, customer service, and internal departments to resolve payment issues, ensuring accurate and efficient reimbursement processes.
- Maintained knowledge of healthcare reimbursement policies, billing procedures, and compliance guidelines.
- Utilized internal systems and Microsoft Excel to track reimbursement claims and reporting metrics.
- Ensured HIPAA compliance and maintained accurate documentation for audit readiness.
Education
High School Diploma -
Skills
- Revenue Cycle Management
- Billing reimbursement
- Claims Processing
- Billing audits
- Accounts payable
- Invoice reconciliation
- Bookkeeping
- QuickBooks
- Microsoft Excel
- Data entry
- HIPAA Compliance
- Customer Communication
Timeline
HR & Accounting Coordinator (Part-Time)
Excell Steel Buildings
08.2021 - 02.2024
Billing Specialist
Myriad Genetics
05.2019 - Current
Payment Posting Specialist
R1 Rcm
01.2018 - 05.2019
Health Data Analyst
R1 Rcm
06.2017 - 01.2018
Broker Reimbursement Specialist
Molina Healthcare
02.2013 - 05.2017