Rene Melton
Hemet,United States
Summary
Efficient billing professional with over fourteen years of experience. 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
15
15
years of professional experience
Work History
Medical Billing Specialist
Hematology-Oncology Consultants
Hemet, CA
06.2009 - 03.2024
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Posted and adjusted payments from insurance companies.
- Located errors and promptly refiled rejected claims.
- Precisely evaluated and verified benefits and eligibility.
- Evaluated patients' financial status and established appropriate payment plans.
- Communicated with patients for unpaid claims for HMO, PPO, Medi-Cal, and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Identified and resolved patient billing and payment issues.
- Trained new employees on multiple medical billing programs and data entry software.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Collected payments and applied to patient accounts.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Liaised between patients, insurance companies and billing office.
Education
West Valley High School
Hemet, CASkills
- Verbal and Written Communication
- Critical Thinking
- Information Updates
- Cost Tracking
- Reviewing Patient Information
- File and Records Management
- Teamwork and Collaboration
- Medicare and Medicaid Processes
- Itemized Statement Preparation
- Records Management
- Claim Processing
- Diagnostic Codes
- Insurance Claim Requirements
- Benefits Verifications
- Insurance Authorizations
Timeline
Medical Billing Specialist
Hematology-Oncology Consultants
06.2009 - 03.2024
West Valley High School