Hi, I’m
Rosa Sanchez
Paramus,NJ
Summary
Dynamic Medical Biller and Payment Specialist with proven expertise at Endoscopy Center of Bergen County in claims processing and denial management. Adept at ensuring HIPAA compliance while enhancing patient satisfaction through effective communication. Skilled in electronic claims and payment posting, driving timely revenue cycles and improving billing accuracy.
Overview
11
years of professional experience
Work History
Endoscopy Center of Bergen County
Medical Biller and Payment Specialist
02.2022 - Current
Job overview
- Experience in processing and submitting medical claims, including electronic and paper claims, ensuring accuracy and completeness.
- Skilled in resolving billing discrepancies, denials, and outstanding balances, working with insurance companies and patients to achieve timely payments.
- Maintaining accurate and confidential patient records, ensuring compliance with HIPAA regulations.
- Providing excellent customer service to patients, answering billing inquiries, and resolving concerns.
- Consolidated patient data from multiple sources to streamline billing process and improve record accuracy.
- Receive, sort and review payments from insurance carriers and patients.
- Identify appropriate accounts for payments posting through automated and/or manual processes.
- Ensuring payments, adjustments, deductibles, copays/coinsurance are accurately applied.
- Identifying secondary insurances and sending out claims to the proper payer.
- Validate posting results and reconcile payments posted against checks or ERA's received
- Research and post unapplied amounts from an EOB or ERA and ensure refunds and/or insurance over payments letters are issued to the correct payer.
- Correcting rejected claims and ensuring it passes the clearinghouse.
Metropolitan Surgery Center
Insurance Verification Specialist
11.2013 - 01.2017
Job overview
- Ensured compliance with HIPAA regulations while managing sensitive patient information during verification processes.
- Updated patient records with accurate, current insurance policy information.
- Reduced patient wait times by effectively coordinating with surgeons, nurses, and support staff.
- Decreased errors in scheduling system through regular audits, identifying discrepancies, and implementing corrective actions when needed.
- Maintained high level of organization in managing appointment calendars for multiple surgeons simultaneously without compromising accuracy or efficiency.
- Increased patient satisfaction with timely communication regarding appointment confirmations and reminders.
- Expedited registration process for new patients by gathering necessary information prior to their arrival at hospital or clinic setting.
- Verified insurance coverage and obtained pre-authorizations.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Educated patients about surgeries and provided treatment plan documentation.
- Answered high volume of phone calls and messages for out patient facility, scheduling, billing , and handling patient inquiries.
Education
Hackensack High SchoolHackensack, NJ
High School Diploma
1999
EastWick CollegeNutley, NJ
Some College (No Degree) from Vascular Sonography And Medical Assistant
Skills
- Electronic claims
- HIPAA compliance
- Insurance verification
- CPT knowledge
- Patient billing
- Medicare and medicaid process
- CMS-1500 billing forms
- Denial management
- Claims processing
- Payment posting
- ICD-10
- Medical claims submission
Languages
Spanish
Native or Bilingual
English
Full Professional
Timeline
Medical Biller and Payment Specialist
Endoscopy Center of Bergen County
02.2022 - Current
Insurance Verification Specialist
Metropolitan Surgery Center
11.2013 - 01.2017
Hackensack High School
High School Diploma
EastWick College
Some College (No Degree) from Vascular Sonography And Medical Assistant
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