Patricia M. Aldape
Harlingen,TX
Summary
Insurance collections professional with strong background in managing accounts receivable and resolving payment discrepancies. Expertise in financial analysis, negotiation, and compliance with regulations. Collaborative team player known for adaptability and consistent achievement of results. Proficient in using collection software, communication, and problem-solving skills to ensure timely and accurate collections.
Overview
31
31
years of professional experience
Work History
Insurance Collection Specialist and HMC Project Manager
Prime Healthcare Management
09.2016 - 12.2023
- Worked out of an account excel spread sheet by payer, MCR Advantage and Veterans Adm. Via web portal account statues, reviewed denial management module technical denials appealed, medical would add on to the module. Worked daily morning reports such as late charges, payment no adjustments, zero payments, credit balance by reviewing EOB’s and ageing report on excel. Denial management would make telephone calls to insurance companies and VA, for appeal status, had a good outcome on appeals, overturned good amount of high dolor claims. On my sixth month I became the Harlingen Medical Center Project Manager. I managed sixteen collectors, trained, reviewed their reports, had weekly meetings with the facility CFO, UR Dept, Coding Dept. Admissions, and our director. Assisted with sending spreadsheets to the coding and DRG validation teams.
Insurance Collector
Hospitalist Now
10.2008 - 08.2016
- Data entry, per facility, (worked two facility) professional billing for Medicare, Medicaid, Managed Care (MCR and Obama care) Commercial insurance plans. Follow up on claims, review denial management module, appealed technical denials, reviewed electronic files 835’s, explanation of benefits for correct reimbursements. Outcomes: Achieved the highest number in productivity in my area, worked daily morning reports such as late charges, payment no adjustments, zero payments, credit balance by reviewing EOB’s and ageing report on excel. Denial management, would contact via telephone and or on insurance portal to insurance companies and VA, for appeal status, had a good outcome on appeals, overturned good amount of high dollar claims, enforcing S.B. 418. Overturned technical appeals. Month end reports, such as Daily Activity Summary, Analysis by Facility, Aging by Billing Code and Reconciliation.
Insurance Specialist Team Lead
VALLEY BAPTIST MEDICAL CENTER
04.1997 - 10.2008
- Trained inexperienced staff members on how to work the Account Ageing Report, the denial module, appealed technical denials, 835 electronic files, review explanation of benefits for correct reimbursement. Outcomes: Achieved the highest number in productivity in my area, worked daily morning reports such as late charges, payment no adjustments, zero payments, credit balance by reviewing EOB’s and ageing report on excel. Assisted in enforcing the new Senet Bill 418 – prompt processing of claim within 45 days on a clean claim. Gave seminars to different teams in the patient accounts dept.
Insurance Billing/Collector
VALLEY BILLING
10.1992 - 04.1997
- Data entry for anesthesia claims for billing, coding, billed, performed follow up on claim status, posted payments, reviewed EOB’s appealed denials. Collected on self-pay accounts. Outcomes: Maintained a superior quality in billing within timely manner and collections for five Anesthesiologists. Kept financial records for four physicians.
Education
High School - Technical Business Office Education, English as a Secondary Language
Tecnologico de Monterrey
Skills
- Team Leadership
- Strong Communication
- Analytical Thinking
- Detailed Oriented
- Customer Service
- Problem Solving
Training
- S.B. 418 Prompt Pay Regulations
- 10 key by touch
- Typing 60 words per minute
- Outstanding customer service
- Outstanding telephone ethics
- Medical terminology
- ICD
- CPT codes
- Microsoft Excel
- Word Outlook
- IDX
- XACTIMED
- Premis
- Medical Manager
- Medisoft
- Ingenious Med Bills
- MEDITEC
- Relay-billing
Timeline
Insurance Collection Specialist and HMC Project Manager
Prime Healthcare Management
09.2016 - 12.2023
Insurance Collector
Hospitalist Now
10.2008 - 08.2016
Insurance Specialist Team Lead
VALLEY BAPTIST MEDICAL CENTER
04.1997 - 10.2008
Insurance Billing/Collector
VALLEY BILLING
10.1992 - 04.1997
High School - Technical Business Office Education, English as a Secondary Language
Tecnologico de Monterrey
Similar Profiles
Samreen ZafarSamreen Zafar
Clinical Documentation Specialist at Prime Healthcare ManagementClinical Documentation Specialist at Prime Healthcare Management
Jin Cassandra TanJin Cassandra Tan
HR Assistant at Prime Healthcare ManagementHR Assistant at Prime Healthcare Management
Esmeralda ChavezEsmeralda Chavez
Patient Account Representative at Prime Healthcare ManagementPatient Account Representative at Prime Healthcare Management
Amber CastilloAmber Castillo
Qualified Mental Health Professional at LaPaz Behavioral HealthQualified Mental Health Professional at LaPaz Behavioral Health
Matthew CortesMatthew Cortes
Wind Turbine Technician at TakkionWind Turbine Technician at Takkion