REBECCA VILATUNA
Miami Lakes,FL
Summary
Efficient billing professional with 14 years of experience. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Currently in process of finalizing Certified Risk Adjustment Coder Course through AAPC. Productive and diligent with passion for resolving discrepancies through attention to detail and creative problem-solving. Passionate about perpetuating company values through impeccable work ethic and drive.
Overview
8
8
years of professional experience
Work History
Senior Collections Specialist
Vohra Wound Physicians
07.2018 - Current
- Team leader for 6 offshore employees, managing offshore users by assigning tasks and keeping track of their training and handling their escalations specifically for Government payers such as Medicare and Medicaid Managed Care accounts.
- Training new employees on workflow and processes.
- Reviewing provider enrollment/credentialing contracts to identify if lacking needed provider information or needing provider to be linked to group.
- Compiling needed information for Medicare Audit requests.
- Filing 3rd level administrative hearing with Judge for Medicare denials and scheduling for these types of appeals.
- Processing billing calls and answering questions from patients and third-party carriers, processing online and paper appeal submissions and refund requests, logging charges within NextGen Software, electronic EMR system
- Handling multiple accounts and providing information regarding outstanding balances to upper management, generating accounts payable reports for management review to aid in financial and business decision making, receiving and sorting mail, preparing packages for delivery and scanned documents
- Correcting, completing and processing claims for multiple payers such as Medicaid Managed Care and Medicare, HMOs/PPOs/EPOs, worker compensation plans, hospice, and outpatient facilities.
- Creating new workflow processes/protocols to enhance efficiency in resolving denials, examining patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable using multiple different payer portals
- Researching payor guidelines to update in house billing and payor guidelines.
- Knowledgeable with CPT and ICD-10 coding for identifying discrepancies for compliance and reimbursement accuracy, communicating with insurance providers to resolve denied claims and resubmissions,
- Performing billing and coding procedures for inpatient and outpatient services, pre-certified medical services along with surgical dressing supplies, maintaining and updated collections tracking spreadsheet to help organize payment information, communicating effectively and extensively with other departments to resolve claims issues, precisely evaluating and verified benefits and eligibility, performed quality audit in accounts and established processes for correcting errors
- Adhering to established standards to safeguard patients' health information, preventing financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable, analyzing complex Explanation of Benefits forms to verify correct billing of insurance carriers.
Medical Billing Specialist
Laura Stevens Physical
02.2016 - 07.2018
- Account manager for five different providers in one office, posted large amounts of payments in timely and efficient manner, patient billing, claims handling, claims appeals, managing patient accounts, handling patient complaints, filling in front office duties when needed and miscellaneous tasks.
Medical Billing Specialist
Med Star Consulting
01.2015 - 02.2016
- Handled medical billing for multiple practices, following up on denials, claims appeals, handling patient concerns, managing patient accounts receivables.
Education
Associate of Applied Science - Medical Administration
Lincoln College
Medical Administrative Assistant Certificate: Medical Administration - undefined
Lincoln Technical Institute
Certification - Certified Risk Adjustment Coder (CRC)
AAPC
Online07.2023
Skills
- A/P and A/R expertise
- Excellent written and oral communication
- Project energy and enthusiasm
- Organizational Skills
- Coding Error Resolution
- Coaching and Mentoring
- Team Oversight
- Leading Employees
- Medical Billing Code Accuracy
- Quickly grasp new routines and explanations; fast learner
- EMR Systems
- Team Oriented
- Financial Management
- Automated processing
- Performance Improvement
- Database Management
Languages
Italian
Professional Working
Spanish
Native or Bilingual
Timeline
Senior Collections Specialist
Vohra Wound Physicians
07.2018 - Current
Medical Billing Specialist
Laura Stevens Physical
02.2016 - 07.2018
Medical Billing Specialist
Med Star Consulting
01.2015 - 02.2016
Associate of Applied Science - Medical Administration
Lincoln College
Medical Administrative Assistant Certificate: Medical Administration - undefined
Lincoln Technical Institute
Certification - Certified Risk Adjustment Coder (CRC)
AAPC
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