Nina Robles
Pasadena
Summary
Detail -oriented revenue cycle professional with a strong foundation in medical terminology, HCPCS coding, and insurance processes. Experienced in claims review, accounts receivable management, and error resolution to support revenue integrity and compliance. Proven ability to identify billing discrepancies, improve claim accuracy, and contribute to efficient revenue cycle operations.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Revenue Cycle Representative
ChapCare/Altamed
Pasadena, CA
07.2023 - Current
- Review encounters to ensure accurate charges driving revenue integrity and compliant billing practices
- Enter and process billing data in Epic (Professional Billing) with a focus on accuracy and timeliness.
- Submit and monitor claims (electronic and paper), resolving edits and rejections in according with payer requirements.
- Project lead for manual charge entry for specialty pharmacy charges.
- Investigate and correct denied or returned claims, ensuring prompt resubmission and reduced delays in reimbursement.
- Manage daily charge review work queues by taking corrective actions on charge review edits.
- Post payments and reconcile remittances from insurance carriers and patients.
- Research unpaid claims and resolve issues to reduce accounts receivable balances.
- Provide patient support by addressing billing questions and explaining account statements.
Accounts Receivable Specialist
RISSER Orthopaedic Group
Arcadia, CA
11.2022 - 07.2023
- Performed daily follow up on outstanding and denied claims to ensure timely reimbursement.
- Prepared and submitted claims, appeals, and supporting documentation for insurance review.
- Conducted insurance verification and eligibility checks.
- Entered patient demographics and billing charges for professional and facility services
- Communicated with insurance carriers to resolve claim discrepancies and payment issues.
Accounts Receivable Specialist
California Medical Business Services
Arcadia, CA
06.2019 - 11.2022
- Managed accounts receivables for multiple clients, including radiology practices and hospital systems.
- Conducted consistent follow up on unpaid and denied claims to optimize collections.
- Submitted claims and appeals while supporting overall revenue cycle operations.
- Answer incoming patient and insurance calls
- Maintained accurate records and tracked claim status to ensure timely resolution of outstanding balances.
Accounts Receivable Specialist
Abeo
Pasadena, CA
06.2017 - 05.2019
- Responsible for organizing and maintaining accounts receivables active files
- Increase cash collection and Decrease aging A/R
- Thoroughly research, correct and resubmit denied claims
- Accurately and effectively create 1st and 2nd level appeals to collect payment
- Professionally discuss issues with patients and collect money from patients
Billing Representative
Namco Enterprises
Pasadena, CA
09.2015 - 06.2017
- Data entry new patient information and perform insurance verifications
- Specialize in processing trauma, cosmetic and plastic surgery claims
- Research, process claims and correct and re-submit denied claims
- Discuss statements and collect patient payments
Accounts Receivable Specialist
Certified Healthcare Billing
Pasadena, CA
06.2014 - 09.2015
- Data entry new patient information and perform insurance verifications
- Process claims and rejected claims
- Research, correct and re-submit denied claims
- Maintain ageing reports for multiple accounts
Education
Anatomy and Physiology
Pasadena City College
Pasadena, CA05-2026
Accredited Medical Program - undefined
North West College
Pasadena, CA01-2014
Skills
- Insurance claims
- Insurance billing
- Medical billing
- Electronic claims
- HIPAA compliance
- Insurance verification
- Customer service
- Billing and collection procedures
- CPT knowledge
- Patient billing
- Accounts receivable
- Insurance claims processing
- Claim submission
- Medicare and medicaid process
- Data entry
- Denial management
- CMS-1500 billing forms
- Payment posting
- ICD-10
- Electronic health record software
- Claims review
- Patient account analysis
- Multitasking and organization
- Accounts receivable management
- Critical thinking
- Patient collections
Certification
- Medical Billing and Coding - Present
- Medical Billing Certification - January 2014 to Present
Timeline
Revenue Cycle Representative
ChapCare/Altamed
07.2023 - Current
Accounts Receivable Specialist
RISSER Orthopaedic Group
11.2022 - 07.2023
Accounts Receivable Specialist
California Medical Business Services
06.2019 - 11.2022
Accounts Receivable Specialist
Abeo
06.2017 - 05.2019
Billing Representative
Namco Enterprises
09.2015 - 06.2017
Accounts Receivable Specialist
Certified Healthcare Billing
06.2014 - 09.2015
Accredited Medical Program - undefined
North West College
Anatomy and Physiology
Pasadena City College
Additional Information
- SKILLS:
- Customer Service
- Data Entry 40 WPM
- Medical Terminology
- ICD 10-CM
- CPT
- HCPCS