Veronica Rincon
Antioch,CA
Summary
Resourceful Medical Billing Specialist experienced in accurate claim submission and effective revenue cycle management. Achieved high productivity and efficiency through strong problem-solving, communication, and time management skills. Focused on optimizing financial operations within healthcare settings to drive organizational growth.
Overview
1
1
year of post-secondary education
24
24
years of professional experience
Work History
Medical Billing Specialist
Lamorinda Pediatrics
Lafayette, California
01.2016 - Current
- Reviewed patient records for accuracy and completeness before submission.
- Verified patient eligibility for insurance coverage, facilitating efficient claim processing.
- Processed medical claims using electronic billing systems for patient services.
- Communicated with insurance providers to resolve claim discrepancies and denials.
- Entered daily payment,ensuring accurate billing and timely reimbursement
- Updated and maintained billing software with accurate patient information regularly.
- Educated parents on insurance benefits and payment options effectively.
- Adhered to HIPAA regulations when handling confidential patient information.
- Posted charges, payments and adjustments.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
- Provided customer service support to patients who had questions about their bills or payments due.
- Submitted refund requests for claims paid in error.
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Prepared billing statements for patients, ensuring correct diagnostic coding.
- Processed credit card payments from patients in accordance with office policy.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Collected, posted and managed patient account payments.
- Monitored past due accounts and pursued collections on outstanding invoices.
- Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
Medical Biller
Muir Diablo Occupational Medicine
Concord, USA
08.2015 - 12.2015
- Processed Workers Comp appeals
- Researched errors on patients claims to ensure reimbursement
- Researched errors on patients' claims to ensure reimbursement
- Audited and rectified invoices with coding discrepancies to ensure accuracy
- Maintaining support documentation for appeals
- Determining write-offs based on dictation review
- Maintained support documentation for appeals to facilitate successful resolution
- Exhibited mastery of ten key skills critical for effective execution of responsibilities.
- Utilized strong organizational skills to manage multiple tasks efficiently.
- Demonstrated ability to balance and prioritize several projects concurrently.
- Maintained a detail-oriented approach to ensure accuracy in all tasks.
Medical Biller
Delta Medical Services
Antioch, USA
02.2015 - 08.2015
- Posted payments and adjustments as needed.
- Processed unpaid and denied claims for appeals and collections.
- Managed all correspondence with clients and vendors to ensure timely communication., follow-ups, answering multiple phone lines and ten key entries.
Medical Biller
Pediatrix medical group
Antioch, USA
01.2008 - 09.2014
- Medical billing in physician's office for four doctors.
- Gained expertise in handling HMO, PPO, Medicare, Medi-Cal, and Worker's Compensation Insurances for effective billing.
- Posted payments and adjustments as needed.
- Processed unpaid and denied claims for appeals and collections.
- Oversee all correspondence, follow-ups, answering multiple phone lines and ten key entries.
Medical Biller
Webster Orthopedic Medical Group
01.2005 - 12.2007
- Managed medical billing processes for four physicians, ensuring timely and accurate submissions.
- Understood various insurance plans, including HMO, PPO, Medicare, Medi-Cal, and Worker's Compensation.
- Posted payments and adjustments as needed.
- Processed unpaid and denied claims for appeals and collections.
- Coordinated correspondence and follow-ups, handling multiple phone lines and key entries efficiently.
Administrator/Medical Assistant
Vatche Cabayan MD
01.2004 - 12.2005
- Oversaw all front office duties, including answering three phone lines and handling patient calls.
- Communication of MRI's Bone Scans, EMGs, Arthrograms, CT Scans, and Authorizations for DME.
- Communicated with patients regarding tens units, braces, and medications.
- Coordinated appointments for doctors and patients to ensure efficient workflow. for doctors and patients.
- Scheduled pertinent authorizations based on approval.
- Oversaw patient flow in and out of rooms, stocked supplies, and scheduled appointments.
Administrative Secretary
Packaging Store
01.2003 - 12.2004
- Managed UPS and FEDEX shipments, handled three phone lines, coordinated shipping and receiving invoices, and maintained stock supplies.
- Prepared correspondence and documentation for internal and external communication.
- Coordinated schedules and appointments for management and staff.
- Managed daily office operations and maintained organized filing systems.
Education
Diploma - Medical Assistant
Silicon Valley College Emeryville
Emeryville, CA 07.2004 - 01.2005
Skills
- Claims processing
- Insurance claims
- Medical coding expertise
- CPT knowledge
- ICD-10 proficiency
- Denial management
- Billing reconciliation
- Payment posting
- Patient billing
- Claim submission
- Electronic claims
- Medical claims submission
- Insurance verification
- Electronic health records
- EHR use
- Medical documentation
- Coding accuracy
- Regulatory compliance
- HIPAA compliance
- Customer service
- Account follow-up
- Patient collections
- Insurance billing
- Balance reconciliation
- Files and records management
- Attention to detail
- Time management
- Problem solving
- Teamwork and collaboration
- Effective communication
- Communication skills
- Organizational skills
- Organizational skills
- Insurance billing
- Communication skills
- EHR use
Timeline
Medical Billing Specialist
Lamorinda Pediatrics
01.2016 - Current
Medical Biller
Muir Diablo Occupational Medicine
08.2015 - 12.2015
Medical Biller
Delta Medical Services
02.2015 - 08.2015
Medical Biller
Pediatrix medical group
01.2008 - 09.2014
Medical Biller
Webster Orthopedic Medical Group
01.2005 - 12.2007
Diploma - Medical Assistant
Silicon Valley College Emeryville
07.2004 - 01.2005
Administrator/Medical Assistant
Vatche Cabayan MD
01.2004 - 12.2005
Administrative Secretary
Packaging Store
01.2003 - 12.2004