Olga T. Huerta
San Antonio,Texas
Summary
Obtain a position within the medical field that allows contributes as an experience medical professional that will allow me to gain more experience and growth within the company.
Overview
17
17
years of professional experience
Work History
Medical Biller and Coder
Castle Hills Outpatient Center
10.2020 - Current
- Managed billing cycles, ensuring timely submission of claims and accurate payment processing.
- Reviewed medical records for coding accuracy, enhancing compliance with industry standards.
- Collaborated with healthcare providers to resolve billing discrepancies and improve revenue cycle management.
- Trained new staff on coding procedures and billing software, fostering a knowledgeable team environment.
- Implemented process improvements that reduced claim denials and increased reimbursement rates.
- Analyzed coding trends to identify areas for improvement within department practices and procedures.
- Led initiatives to streamline workflows, resulting in enhanced operational efficiency and productivity.
- Worked closely with physicians to accurately assign ICD-10 diagnostic codes for optimal reimbursement rates from insurance companies.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Played a pivotal role in maintaining positive cash flow within the organization by ensuring timely submission of clean claims and diligent follow-ups on outstanding payments.
- Assisted patients with understanding their insurance coverage and financial responsibilities, fostering positive relationships and trust between the practice and its clients.
- Increased accuracy in medical claims submissions by conducting thorough reviews of patient records and insurance information.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
Medical Biller
Spindletop Pain Management
05.2020 - 10.2020
- Processed insurance claims efficiently, ensuring accurate coding and timely submissions.
- Reviewed patient bills for accuracy, resolving discrepancies with healthcare providers.
- Coordinated with insurance companies to clarify billing issues, expediting resolution processes.
- Maintained detailed records of billing transactions and communications for auditing purposes.
- Implemented process improvements that streamlined claim submissions and reduced errors.
Medical Biller Specialist
Concords Practice Management
06.2018 - 04.2020
- Conducts appropriate account activity on accounts by contacting government agencies, third party payers, and patients/guarantors via phone, e-mail, or online. Continue collection activity until account is resolved. Verifies existing patient’s documentation on to see if claims are HMO/PPO/EPO or authorization/referral is required. Verifies eligibility and benefits.
- Identifies delinquent accounts, aging period and payment sources. Process delinquent unpaid accounts by contacting, third party payers, resubmit claims to third party payers, and appeal by utilizing payer websites.
- Recruit and develop network for a region and set of providers; Facilitate and oversee to the provider set-up and contract configuration to ensure accurate claims adjudication.
- Contacts patients or physician’s office to obtain proper documentation for date of service and process claims. Insures that the CPT or the diagnoses is the correct for the patients.
- Reviews payment posting for accuracy in the contract and proper payment from the carriers. Responsible for reviewing, researching, investigating and triaging all types of claims, appeals and grievances. Proficiency in looking at claims for proper ICD 9/10 coding and reprocessing thru EDI.
- Identifies the revenue of the cycle of payers processing and procedures of the gaps and developed proper refunds and recoupments/reimbursement.
Medical Biller Specialist
Fertility of San Antonio
01.2018 - 06.2018
- Analyze patient charges been properly coded, create billing batches for a wide range of physicians. Uploads ERA’s, run report and label batches for import to payers.
- Bill per procedure and appropriate contract. Verify procedures and check modifiers.
- Review charts for accurate and timely coding that is supported by medical record documentation.
- Evaluate the quality of clinical documentation to identify incomplete or inconsistent documentation that could impact the quality of data being reported.
- Billed all secondary insurance, followed up on all medical payments.
- Acquired knowledge of billing commercial, Medicare/Medicaid and all secondary carries HMO/PPO/EPO.
- Calculate correct fee and process billing transactions. Print bills. Post billings. Send bills.
Office Manager
Texas Family Psychiatry
06.2008 - 09.2017
- Working with behavioral health professionals, to include physicians, and psychologist.
- Responsible for schedule resources and billing collections and reimbursement of claims processing.
- Insurance verifications, posting payments, reviewing charges before processing billing to insurance companies.
- Collection of copays and deductibles, creation of reports and monthly close.
- Evaluate and provide appropriate documentation for the third-party payer CPT denials to maintain the original CPT assignment.
- Worked collaboratively with staff: RN and medical personnel on clinical charting procedures for accurately billing process.
- Audit codes and professional fee services performed by providers from medical records according to ICD-10, CPT, and CMS guidelines. Review and quality assurance on clinical notes for billing process.
- Process accounts to 3rd party (HMO/PPO/EPO) providers in a timely matter before deadline and collect on past due accounts.
- Follow upon claims and process denial for reimbursement thru insurance companies.
- Obtain status on aging reports for outstanding claims/denials.
Education
High School - Basic/Diploma
John F. Kennedy
Skills
- Typing 50-55 wpm
- Proficient Computer Skills
- Operator Line 1-25
- Data Entry 14,000 kspm
- Insurance Verification/Forms 485/T19/F2F
- Scheduling/Referrals/Authorizations
- Account Receivable/Account Payable
- Billing/Posting/EOB’s Reconciling
- Medical Terminology CPT/HCPCS/ICD10
- EMD’s Medisoft
- MOMS/Isalous Program
- Medicare/Medicaid/Advanced MD
- ERA/EFT/EDI 835 & 837 Remittance
- Ability/Avaiity & All Scripts
- EMR/Navinet/THMP
- Appeals/Follow-ups Reconciliation
Timeline
Medical Biller and Coder
Castle Hills Outpatient Center
10.2020 - Current
Medical Biller
Spindletop Pain Management
05.2020 - 10.2020
Medical Biller Specialist
Concords Practice Management
06.2018 - 04.2020
Medical Biller Specialist
Fertility of San Antonio
01.2018 - 06.2018
Office Manager
Texas Family Psychiatry
06.2008 - 09.2017
High School - Basic/Diploma
John F. Kennedy
Cover Letter
- Olga T. Huerta
- San Antonio Texas
- 210-232-6422 mobile
- Email: olgahuerta@att.net
- Dear Human Resource;
- I am writing in connection with the job opening within your company which was posted in the official website. My experience working within the health industry has been over ten years. I’ve had the experience working on several team projects; which includes working with physicians’ offices, auxiliary office, and presently working for a billing company to process claims and payment for several physicians.
- As addition to working experience in healthcare area, I am also capable of handling multiple jobs at once and finish them before the deadline. I’m also aware of working under pressure and able to complete the job as excellent and with integrity. The level of time and task management skills that I have is exceptional. I have superb skills in problem solving and decision making task. I am also able to communicate well in written and oral communication in English or Spanish.
- Enclosing I am attaching my resume with detailing my skills and job experiences. Should you have any quarries on my qualifications, you can contact me through email address or cell phone number listed.
- Thank you for time and consideration. I look forward to speaking with you and setting up an interviewing with you.
- Sincerely
- Olga Huerta