MIRANDA MADRID
Pacoima,CA
Summary
Results driven Accounts Receivable professional with over 5 years of experience in account management, revenue generation and medical billing and coding. Accomplished in developing strategies to improve workflows and processes and actualizing procedures to enhance revenue generation. Demonstrated leadership skills guide teams towards success, optimize performance and sustain organizational success.
Overview
6
6
years of professional experience
Work History
Senior Accounts Receivable Auditor
Western Drug Medical Supply
Glendale, CA
09.2018 - Current
- Demonstrated proficiency in claim processing and resolving provider dispute resolutions for over 200 contracted payers including HMOs, PPOs, Medi-Cal, Medicare, hospitals.
- Managed a database of fee schedules and division of financial responsibility for multiple payers for outpatient/inpatient, professional and secondary claims.
- Audited procedures to monitor and improve efficiency of billing and collection operations.
- Conducted comprehensive financial analysis using Microsoft Excel to assess and evaluate the financial performance of various contracted payers.
- Maintained professional and effective communication with internal and external stakeholders, including contracted payers, to resolve issues and discrepancies promptly.
- Extensive knowledge of CPT, HCPCS, ICD-10 coding reimbursement guidelines.
- Experienced with EDI technology and processing electronic claims for multiple types of payers.
- Responsible for responding and managing grievances submitted by patients.
- Managed and trained over 30 employees for different departments across 2 locations.
- Developed the training and supervision of an offshore team specialized in claim processing, creating efficient processes and manuals.
- Compliance: Provided guidance to improve business' understanding of related laws and regulatory requirements.
Education
Bachelor of Arts - Psychology
University of California, Los Angeles
Los Angeles, CA06.2018
Skills
- Medical Billing
- Knowledge of HMOs, Medicare, Medicaid
- Confidential Records Maintenance
- Accounts/Claims Reconciliation
- Insurance Contracts, Appeals, EOBs
- Project Management
- Financial Analysis
- Regulatory Compliance
- CPT and HCPCS Coding
- Electronic Health Records (EHR) Systems
Accomplishments
- Gained expertise in all aspects of medical billing including filing claims, refund requests, completing appeals, and adjusting payments.
- Committed to staying updated with all insurance requirements, including financial responsibility, fee-for-service, and managed care plans.
- Identified weaknesses of existing control systems and developed and implemented new strategies resulting in a 30% reduction in billing errors.
- Liaised with the business and billing departments to resolve errors in high balance accounts resulting in the recovery of over $250,000 in payments.
Timeline
Senior Accounts Receivable Auditor
Western Drug Medical Supply
09.2018 - Current
Bachelor of Arts - Psychology
University of California, Los Angeles
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