Susana Arguello

• CPT input and ICD-9 coding for multiple specialties including Pulmonary, Critical Care, Infectious Disease, General Surgery, ENT, Family Practice, Neurology, and Internal Medicine
• Work effectively with physician staffs on coding, billing and insurance issues
• Excellent guest relations skills with physicians, patients and payers
• Knowledgeable about HIPAA Guidelines, Medicare Compliance issues, LCD, CCI, and RVRBS, TARS, Authorizations, Medicare 0 pays, medicare redetermination
• Accurately post and balance patient payments
• Effective follow-up on open claims to ensure timely resolution and closure (online, by phone and appeal letters)
• Accurately process medical claims to various insurance carriers to ensure proper and correct payment (Medicare, Medical, HMO’S, PPO)
• Maintain current working knowledge of CPT, HCPCS, and ICD-9 coding principles, government regulations, protocols and third party requirements regarding billing
• Accurately evaluate the accuracy of provider charges, including dates of service, procedures, levels of care, locations, diagnosis, patient identification, and provider signature
• Create patient accounts with accuracy including verification of eligibility
• Provide outstanding customer service to clients
• Successful multi-tasking with various data bases, internet, intranet, telephone, and faxing
• Manage multiple accounts to ensure that preparation is up to date to ensure timely billing
• Obtain authorizations and accurately check eligibility.

Collections-follow up on claims with different payers medi-cal,Medicare, and private insurances and HMO.