REBECCA SIERRA
Fillmore,USA
Summary
Experienced Accounts Receivable Specialist and Medical Biller with strong knowledge of ICD-10, CPT, and HCPCS coding, including accurate modifier usage for proper claim submission and reimbursement. Skilled in managing the full revenue cycle process, from charge entry and claim submission to denial resolution and payment posting. Proven ability to analyze EOBs, correct coding errors, and communicate effectively with payers to reduce denials and maximize collections. Detail-oriented, efficient, and committed to maintaining compliance with Medicare, Medicaid, and commercial insurance guidelines.
Overview
14
14
years of professional experience
Work History
AR Specialist
XIFIN, INC
San Diego, California
01.2023 - Current
- Researched and analyzed denied insurance claims to determine the root cause and resolution.
- Corrected and resubmitted claims, in compliance with payer guidelines and industry regulations.
- I talked with insurance companies to appeal denials and to secure proper reimbursement.
- Collaborated with billing teams and providers to gather necessary documentation and support successful appeals.
- Monitored denial trends and provided feedback to management to reduce future rejections.
- Maintained accurate records of claim status, appeal efforts, and payer correspondence.
Medical Billing Representative
Dr. Proffett MD Family Practice
Moorpark, USA
07.2016 - 01.2023
- Type 60 wpm
- Ten Key (by touch)
- Medisoft System
- Medtex System
- Outlook
- Professional Encoder
- Ptox System
- Inputting patients' demographics, creating a clean superbill, proper CPT, ICD-10, and modifier usages, maintaining proper medical documentation, claims submission, claims adjudication, monitoring claim adjudication, payment posting, aging report, patient statement preparation, and statement follow-up.
- Provider credentialing, a good understanding of contracts, pricing, processing policies, and procedures per Medicare Fee Schedule, and Office Alley clearinghouse submissions.
- Processed patient claims using electronic medical billing software.
- Reviewed and corrected billing discrepancies for accurate claim submission.
- Coordinated with insurance providers to verify patient eligibility and benefits.
- Maintained organized records of patient accounts and billing transactions.
- Communicated with patients regarding outstanding balances and payment options.
Medical Biller
Stamark Micro Systems, INC
Ventura, USA
05.2011 - 07.2016
- Responsible for inputting patient demographics, entering super bills, hospital charges, and convalescent charges, collecting payment for healthcare plans on outstanding claims, posting payments, and adjustments within the specified time frame.
- Can abstracting procedure code CPT and ICD from doctor notes, knowledgeable of HCPCS codes, determining payments that have been made in accordance with company practices and procedure, quality control of all coding entry corrected codes as needed for the pre-bill report.
- Responsible for verification of eligibility and billing coordination, electric billing/HCFA 1500 forms, a good understanding of contracts, pricing, processing, HMO
Education
Certication of Completions - Medical Terminology
Santa Barbara Business College
Santa Barbara, CA07.1998
High School Diploma -
Santa Barbara I ligh School
Santa Barbara, CA06.1984
Skills
- Billing and collection procedures
- Information confidentiality
- Chart auditing
- Account reconciliation
- Medical management system
- Team DME system
- Microsoft Excel
- Microsoft Word
- Type 60 wpm
- Ten key (by touch)
- Medisoft system
- Medtex system
- Outlook
- Professional encoder
- Ptox system
- Practice Mate
Timeline
AR Specialist
XIFIN, INC
01.2023 - Current
Medical Billing Representative
Dr. Proffett MD Family Practice
07.2016 - 01.2023
Medical Biller
Stamark Micro Systems, INC
05.2011 - 07.2016
Certication of Completions - Medical Terminology
Santa Barbara Business College
High School Diploma -
Santa Barbara I ligh School
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