Olga Velazquez
Calexico,CA
Summary
Results-driven Medical Biller with proven expertise at SCPS in insurance claims processing and denial management. Enhanced revenue collections through meticulous claim submissions and effective communication with insurance providers. Adept at fostering client relationships and delivering exceptional customer service, contributing to improved patient satisfaction and streamlined billing operations.
Overview
4
4
years of professional experience
Work History
Medical Biller
SCPS
10.2021 - Current
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Filed and updated patient information and medical records.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Collected payments and applied to patient accounts.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Maintained compliance with industry regulations by staying updated on changes to medical billing codes and requirements.
- Delivered timely and accurate charge submissions.
- Collaborated with healthcare providers, ensuring accurate documentation for seamless billing operations.
- Acted as liaison between healthcare providers and insurance companies; resolved disputes quickly while maintaining positive relationships.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Resolved discrepancies in accounts receivable reports, contributing to improved cash flow management.
- Established strong relationships with insurance representatives, facilitating prompt resolution of billing issues.
- Improved patient satisfaction levels with clear explanations of their financial responsibilities and available payment options.
- Trained new team members in medical billing software, increasing efficiency within the department.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Reviewed outstanding balances owed by patients; initiated collection actions if necessary resulting in improved account recovery efforts.
- Assisted patients in understanding insurance benefits, leading to a positive experience during their visit.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Negotiated with insurance providers to resolve payment disputes, ensuring fair compensation for services rendered.
Education
Certified Professional Coder
AAPC
Skills
- Insurance claims
- Insurance billing
- Medical billing
- Electronic claims
- HIPAA compliance
- Insurance verification
- Customer service
- CPT knowledge
- Billing and collection procedures
- Patient billing
- Accounts receivable
- Insurance claims processing
- Claim submission
- Medicare and medicaid process
- Data entry
- CMS-1500 billing forms
- Denial management
- Claims processing
- Payment posting
- ICD-10
- Electronic health record software
- ICD-10 proficiency
- Patient account analysis
- Claims review
- Medical claims submission
- Records management
- Multitasking and organization
- Software use
- Critical thinking
- Teamwork and collaboration
- Collection calls
- ICD-10 coding
- Patient collections
Languages
Spanish
Native or Bilingual
Timeline
Medical Biller
SCPS
10.2021 - Current
Certified Professional Coder
AAPC
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