Teresita De Castro-Alcantara
Sparks,NV
Summary
Familiar with commercial insurance. Works with insurance companies to resolve problem on claim inquiries, denials and disputes. Brings can-do attitude with medical professionals, providers and patients to handle within office environment.
Loyal and dedicated employee.
Overview
18
18
years of professional experience
Work History
Medical Biller
Nevada Advanced Pain Specialists
Reno, Nevada
08.2014 - 11.2024
- Reviewed patient insurance information to ensure accuracy and completeness of claims submission.
- Verified medical codes for diagnosis, treatments, procedures and supplies using ICD-10 coding system.
- Maintained up-to-date knowledge of government regulations related to healthcare reimbursement policies and procedures.
- Submitted electronic claims to various insurance carriers.
- Researched discrepancies between billed charges and payments received from insurance companies or other third party payers.
- Performed follow up activities on unpaid claims with insurance companies or other third party payers by phone or written correspondence.
- Created monthly aging reports to identify delinquent accounts for review by management team.
- Completed and submitted appeals for denied claims.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Liaised between patients, insurance companies, and billing office.
- NOTE: Awarded 2023 Employee of the Year
Account Representative
Renown Regional Medical Center
Reno, NV
09.2010 - 08.2014
- Reviewed patient accounts for accuracy and completeness, and submitted claims to insurance companies.
- Resolved discrepancies on patient accounts by contacting the insurance companies or patients.
- Verified accuracy of account information and processed adjustments as needed.
- Provided customer service to both internal and external customers regarding billing inquiries.
- Reconciled daily deposits with bank statements and posted payments into appropriate accounts.
- Performed data entry functions for entering new patient information into the system.
- Processed credit card payments and other forms of payment received from patients or insurance companies.
- Tracked aging reports of unpaid claims and took corrective action when necessary.
- Attended training sessions related to billing practices or updates from insurance carriers.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Completed and submitted appeals for denied claims.
- Submitted appeals using provider portals and phone communication.
- Submitted claims to insurance companies.
- Performed insurance verification, pre-certification and pre-authorization.
- NOTE: Also worked for the same position during 02/2006 to 10/2006
Account Representative
Reno Radiological Associates
Reno, Nevada
10.2006 - 09.2010
- Worked for more than 15 Radiology doctors.
- Obtain missing or incomplete demographic insurance informatiom needed for primary billing.
- Process all patient and insurance correspondence.
- Verbal and wrtten appeals of claims as needed.
- Research unpaid claims and make phone calls to follow up on payments.
- Coverage for receptionist on a weekly rotation.
- NOTE: Also worked for the same position during 12/1997 to 09/2005
Education
Some College (No Degree) - Medical Secretary
Los Angeles City College
Los Angeles, CAHigh School Diploma -
Lake Shore Educational Inst
PhilippinesSkills
- Medical claims submission
- Insurance verification
- CMS-1500 billing forms
- Electronic claims
- Teamwork and collaboration
- Billing codes
- Account follow-up
- Insurance billing
- Commercial and private insurance
- Verbal and written communication
Timeline
Medical Biller
Nevada Advanced Pain Specialists
08.2014 - 11.2024
Account Representative
Renown Regional Medical Center
09.2010 - 08.2014
Account Representative
Reno Radiological Associates
10.2006 - 09.2010
Some College (No Degree) - Medical Secretary
Los Angeles City College
High School Diploma -
Lake Shore Educational Inst
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