NINFA GARCIA
Summary
Dependable and hardworking candidate eager to secure a coding position. Ready to help team achieve company goals.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Business Office Specialist 1
DHRHealth
Edinburg, TX
09.2018 - Current
- Work on claim submission, verifying that ICD-10 and CPTs are correctly used
- Fix rejections that are received on a daily basis from the clearinghouse
- Review and correct ERAs and paper denials by adding appropriate modifier/s and/or correcting diagnosis/es
- Access medical records for appeals and denials, submit to corresponding plan and follow up with insurance company for final decision
- Reverse patient charges if incorrect adjustment due to denial findings
- Enter charges for several clinics/specialties
- Verify eligibility
- Balance payments for each batch posted
- Programs use: Medisoft, Cerner, Paragon, Microsoft and Excel
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Worked effectively in fast-paced environments.
- Excellent communication skills, both verbal and written.
- Passionate about learning and committed to continual improvement.
Medical Biller and Coder
Northwest Eye Physicians
Arlington Height, IL
01.2000 - 01.2018
- Coded surgeries
- Processed daily payments from insurance companies and patients
- Scrub claims
- Correct coding errors
- Verify eligibility and benefits
- Online claim submission and ERA
- Appeal to insurances for payment
- Retrieve Electronic Remittance Advice
- Reviewed patient accounts
- Prepared and mailed statements to patients
- Answer and resolve patient billing inquiries
- Follow up on insurance and patient aging accounts
- Keep constant contact with collection agency
- Kept AR report low
- Used MDOffice for billing and appointment scheduling and IOPracticeware for EHR
- Trained new front desk employees (check in and check out)
- Helped front desk when needed by answering phones, schedule appointments, check in and check out.
Education
Medical Transcribing Certificate -
Texas State Technical College
Harlingen, TX01.1995
High School Diploma -
Donna High School
Donna, TX01.1992
Skills
- Coding
- ICD-10
- Medical terminology
- Claim entry and payment posting
- Submitting claims
- Denial Resolution
- Claim submission
- Account reviews and assessment
- Collections experience
- Healthcare compliance
- Claims Management
Personal Information
Title: CPC-A
References
Upon request
Affiliations
- AAPC
Certification
- Licensed Coder
Timeline
Business Office Specialist 1
DHRHealth
09.2018 - Current
Medical Biller and Coder
Northwest Eye Physicians
01.2000 - 01.2018
Medical Transcribing Certificate -
Texas State Technical College
High School Diploma -
Donna High School