Hi, I’m
Talia Barajas
Elgin,IL
Summary
Bilingual Medical biller and coder with exceptional communication and team collaboration skills. Capacity to multitask, manage completing priorities. Trained in a range of medical and billing software. Effective both as a team player and independent worker and quickly adaptable to new settings and environments. Rapid demonstrated growth in most recent job title and interested in progressing career in Medial Billing.
Overview
9
years of professional experience
Work History
CHICAGO AUTISM AND BEHAVIOR SPECIALISTS
INSURANCE SUPERVISOR
12.2018 - 08.2023
Job overview
- Responsible for the supervision of the billing functions, including day-to-day activities of the team, coordinating efforts to expedite payment of accounts, and initiation of goals & processes
- Supervise billing staff performance of tasks associated with billing and collection from third-party payors
- Monitors and ensures billing is correct and timely
- Ensures timely submission and acceptance of claims to all payors on a scheduled day each week
- Ensures third-party payments are applied to client accounts according to accounting processes
- Reviews and resolves issues related to claim generations, clean claim ratios, rejected claims, & denied billing
- Identifies and follows up/ collects on incorrectly paid accounts
- Elevates issues with payors and reports improvement plans, as appropriate
- Oversees the client authorization process and ensures required paperwork is submitted to insurance carriers by due dates and current authorizations are entered into CentralReach accurately and timely
- Participates in appeals process
- Obtains single case agreements
- Track, analyze, and develop action plans to achieve KPls & goals
- Participates in the development of department and clinic processes
- Ensures development of team by conducting training for new and existing staff and completes regular reviews
- Communicates issues that are preventing timely and accurate billing to CEO
- Researches current insurance laws, processes pertaining to ABA
- Complied with established internal controls and policies
- Follows HIPAA guidelines in handling client information
BARRINGTON SMILES
Front Desk/Billing Specialist
10.2017 - 05.2018
Job overview
- Greeting and assisting patients, answering any questions regarding patient’s insurance benefits and accounts, Preparing the schedule and attaching services for the following day
- Verifying eligibility with insurance companies before patient's appointments to ensure payment
- Posting checks, Work and following up on unpaid claims with insurance
- Register new patients using EagleSoft
- Answer and manage incoming calls
- Schedule appointments, confirm upcoming appointments
- Collect payments from patients at time of treatment
- Inform patients of financial treatment plan options
- Prepare claim forms for dental insurance
- Attach supporting documents for insurance claims such as X-rays and Perio charts
- Posting payments to patient's accounts
- Call Insurance companies to follow up on unpaid claims.
GREATER ELGIN FAMILY CARE CENTER
Medical Billing Specialist
01.2015 - 01.2017
Job overview
- Clearly communicated with patients, clerical staff, and insurance companies to ensure that claims and billing documents are effectively managed
- Oversaw maintenance and updating of procedures and diagnosis codes and determined appropriate solutions
- Tracked third-party payments and accurately entered data into databases
- Utilize Viatrack (Clearinghouse) to upload and track claims and manage A/R aging procedures
- Collaborate with clerical staff and insurance companies to improve patient experiences
- Correct procedures and diagnosis codes and quickly conduct follow-ups on identified unpaid accounts
- Enter data from third-party payments into databases.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Located errors and promptly refiled rejected claims.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Identified and resolved patient billing and payment issues.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Collected payments and applied to patient accounts.
- Posted and adjusted payments from insurance companies.
PRESENCE SAINT FRANCIS HOSPITAL
Volunteer
01.2015
Job overview
- Gained valuable experience in a healthcare setting completing various responsibilities including lab runs and patient transport
- Read information and explained content of documents to patients when needed
- Inform patients, visitors, and families on procedures and answer general inquiries as reception support
- Transport patients and accurately convey information from written and printed documents.
Education
Center For Employment Training, Chicago, IL
Medical Insurance Billing & Coding Certificate from Medical Insurance Billing
05.2015
Skills
- CMS 1500, UB04 Claims
- Collections Letters
- CPT, ICD10, HCPCS Codes
- Customer service
- Communication
- Posting payments
- Claims processing
- Claims adjusting
- Insurance audits
- Negotiation
- Conflict-resolution
- Time management
- Quality control
Timeline
INSURANCE SUPERVISOR
CHICAGO AUTISM AND BEHAVIOR SPECIALISTS
12.2018 - 08.2023
Front Desk/Billing Specialist
BARRINGTON SMILES
10.2017 - 05.2018
Medical Billing Specialist
GREATER ELGIN FAMILY CARE CENTER
01.2015 - 01.2017
Volunteer
PRESENCE SAINT FRANCIS HOSPITAL
01.2015
Center For Employment Training
Medical Insurance Billing & Coding Certificate from Medical Insurance Billing
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