SANDRA LEZCANO

Work History

Ghouri Medical Clinic

08.2015 - Current

Served as primary contact for all credentialing matters internally and externally
Verified & Monitored physician to ensure compliance with state and federal law
Carefully prepared, reviewed and submitted patient statements
Consistently ensured proper coding, sequencing of diagnoses and procedures
Interpreted medical reports to apply appropriate ICD-10 CPT-4 and HCPCS codes
Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
Utilized electronic medical record systems to store, retrieve and process patient data.
Communicated effectively with staff, patients, and insurance companies by email and telephone.
Assisted in training new staff on medical record processing and filing procedures.
Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
Communicated with insurance companies to research and resolved coding discrepancies.
Utilized Internet and other resources to research newly identified diagnoses and procedures.
Reconciled accounts receivable to general ledger.

Adams Family & Cosmetic Dentistry

03.2015 - 12.2022

Greet patients as they arrive at the dental practice and inquire into their purpose of visit
Obtain patient information such as demographics and create appropriate electronic files
Obtain patients' insurance information and ensure that coverage is verified, by contacting insurance companies through the telephone, and ins portals
Manage patient inflow, ensuring that appropriate volume is maintained, through proper scheduling
Skilled in managing office records and files, creating and maintaining records, and overseeing filing systems.
Maintained office supplies by taking inventory and submitted orders for low-stock items.
Answered multi-line phone system to respond to inquiries and transfer calls to correct departments and personnel.

Kidney & Hypertension Associates PC

09.2012 - 03.2015

Acted as liaison between the business department, billers and third-party payers in resolving billing/ reimbursement accuracy
Posted and adjusted payments from insurance companies and patients
Verified and abstracted all medical data to assign appropriate codes for office procedures and hospital procedures
Provided thorough supervision for day-to-day operations of facility in accordance with set policies and guidelines
Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
Observed strict confidentiality and safeguarded all patient-related information
Responded to customer concerns and questions on daily basis.
Audited and corrected billing and posting documents for accuracy.
Handled account payments and provided information regarding outstanding balances.
Maintained accurate records of customer payments.

John A. DeClue

02.2008 - 12.2013

Accurately prepared and submitted large volume of medical claims to insurance companies electronically and manually
Evaluated pending claims to identify and resolve problems
Oversaw daily collections and accounts receivable activities daily to maximize collections and reduce aged accounts
Posted Charges, payments, and adjustments
Served as primary contact for all credentialing matters internally and externally
Verified & Monitored physician to ensure compliance with state and federal law for credentialing purposes
Interpreted medical reports to apply appropriate ICD-10, CPT-4 and HCPCS codes
Served as liaison between management, clinical staff and community
Provided thorough supervision for day-to-day operations of facility in accordance with set policies and guidelines
Observed strict confidentiality and safeguarded all patient-related information.
Prepared and performed written reports of audits.
Reviewed chart documentation to support ICD-10 and CPT codes and took action if documentation was not coded appropriately.

Edwin Page, ENT & Associates

05.1998 - 01.2009

Interpreted medical reports to apply appropriate ICD-10, CPT-4 and HCPCS codes
Maintained accurate records of customer payments.
Used data entry skills to accurately document and input statements.
Monitored outstanding invoices and performed collections duties.
Handled account payments and provided information regarding outstanding balances.
Completed appeals and filed and submitted claims
Posted charges, payments and adjustments
Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information
Efficiently performed insurance verification and pre-certification and pre-authorization functions
Thoroughly investigated past-due invoices and minimized the number of unpaid accounts
Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.