Rocio P. Molina-Felix
Perris,CA
Summary
Experienced medical biller and A/R collector who has proven organization, customer service, and project management skills proven by 23 years of successful experience in the medical administration field. Demonstrating integrity and time management skills.
Service-focused, technically skilled, and hardworking professional experienced professional with over 15 years of experience as an assistant manager-supervisor.
Advanced skills in MS Office Suite (Word, Excel, Access, PowerPoint, and Outlook); proved ability to learn new computer programs quickly.
Expert interpersonal and communication skills. Ability to train, motivate, and supervise. Tactful handling of sensitive, confidential issues; ability to resolve customer complaints; all promptly.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Medical Billing Specialist
CalMHSA (California Mental Health System Authority)
05.2023 - 08.2024
- Auditing and preparation of billing files. Correcting CPT/HCPCs selected by clinicians, adding proper modifiers, as necessary.
- Preparing of billing files for uploading to the State in addition to preparing proper forms for county review and approval for file submission for Medi-Cal and Medicare.
- Preparing paper claim files and electronic claim files for Commercial Insurances.
- Weekly meetings with the assigned County for proper guidance on any concerns, training if necessary and reporting of current billing status.
- Resolving of Helix tickets. Testing of reported error, replicating error or fixing the error with proper documentation for training or escalation if necessary.
- Downloading of 835 Files for automatic payment application into system. Review of file and proper adjustment application if necessary.
AR Collection Supervisor
Palm Consulting DBA Haven Home Health
Signal Hill, CA
04.2015 - 03.2023
- Supervise five employees.
- Help in hiring, training, and coaching of the collection staff and Interns.
- Submitting appeals first and second level for denied or underpaid claims.
- Responsible for approved time off and bi-weekly timesheets.
- Data entry and billing auditing NP coding for claim submission.
- Downloading 835 ERAs, matching of payments to bank statements.
- Insurance follow up both online and by phone.
- Payment application, posting.
- Month end reporting for upper management.
- Aging preparation and auditing of employee work.
- Preparing and depositing payment batches for multiple companies.
Billing Specialist
Memorial Sports & Internal Medicine
Los Alamitos, CA
06.2014 - 04.2015
- Review doctor coding/billing in system.
- Prepare and upload claims electronically.
- Prepare and mail paper claims & patient statements.
- Incoming - outgoing patient calls.
- Claim follow up online or placing outgoing calls to various insurances.
- Data entry (post patient and insurance payments into system)
- Month end reporting
Billing Supervisor
Memorial HealthCare IPA
Signal Hill, CA
06.2004 - 06.2014
- Supervise eleven employees.
- Provide billing support to all Billing Clerks.
- Monitoring of all invoicing, and billing on a weekly basis.
- Responsible for approved time off and bi-weekly timesheets.
- Maintaining daily logs of staff productivity and auditing of worked accounts.
- Running and posting daily credit cards.
- Month-end closing, preparation of AR reports and Analysis.
- Accountable for Patient complaints and resolution.
- Creating and sending provider disputes for underpaid or denied claims.
- Creating and sending collection reports for outstanding AR.
- Daily up-dating of data sets. Uploading of electronic claims to clearinghouse and various HMO in 5010 spec and 4010 spec for multiple providers.
- Liable for tracking refund requests for insurance and patient overpayments.
- Help in hiring, training, and coaching of the billing clerks.
- Aid with the performance evaluations.
- Ordering of office supplies and distribution.
Assistant Client Manager
Marina Medical Billing Service Inc
Cerritos, CA
11.2000 - 06.2004
- Insurance follow up for HMO, PPO, Work Comp, and Medicare by phone or online.
- Self-pay collector. Placing outgoing calls, as necessary.
- Self-pay credit balance, reviewing accounts for prompt refunds.
- Review of Insurance refund requests.
Skills
- Bilingual in Spanish (speaking, reading, and writing)
- Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)
- Professional Billing for ER, PCP, Urgent Care, GYN, Home Health, Mental Health, and Substance Abuse
- Knowledge of CMS 1500 and UB-04 claim forms
- EHR Systems: Allscripts, NextGen, Health Wyse, Athena, E-Clinical, Well Sky, SmartCare
Certification
- Medical Billing and Coding Certificate Jan-2014
- Medical Terminology for HealthCare Professionals July-2012
Timeline
Medical Billing Specialist
CalMHSA (California Mental Health System Authority)
05.2023 - 08.2024
AR Collection Supervisor
Palm Consulting DBA Haven Home Health
04.2015 - 03.2023
Billing Specialist
Memorial Sports & Internal Medicine
06.2014 - 04.2015
Billing Supervisor
Memorial HealthCare IPA
06.2004 - 06.2014
Assistant Client Manager
Marina Medical Billing Service Inc
11.2000 - 06.2004