Yahaira Mercado, NCICS, CH-CS
Senior Medical Billing Specialist
Camden,NJ
Summary
Self-motivated service-focused professional seeking to leverage both experience and education a medical billing specialist. Detail-oriented and organized individual who exemplifies professionalism, and an ability to manage multiple projects and tasks at any given moment. Demonstrated history of successful financial management and customer service, while maintaining a positive company image. Highlighted leadership qualities and the ability to work with individuals from varying backgrounds, while promoting team values. Driven partner eager for professional growth, increased responsibility, and the opportunity to apply extensive experience in a challenging environment.
Overview
11
11
years of professional experience
2
2
Certification
Work History
Senior Medical Billing Specialist
Project H.O.P.E., Inc
Camden, NJ
12.2023 - Current
- Denials, Claim Appeals, Insurance Eligibility, Claim follow up, Credentialing, No-show report, Open encounter report, LOA, CAQH, NPPES, PECOS, UDS Reports, FTCA, Payer Enrollment, End of month closing financial reports, AR reports, Payment posting, Claim appeals, FQHC billing, Icd 10 coding, HCPCS and CPT, Patient Statements, 340 B Pharmacy Program Audits, Daily charges submission, Conducting financial meetings, Mail, Research for meetings, Covid HRSA programs, Family Medicine Billing, Mental Health Billing, Wraparound Reports, HRSA, Policy and Procedures, Sliding Fee Program, PE (Presumptive Eligibility), IT, Computer Setup
Medical Billing Specialist
Project H.O.P.E., Inc
Camden, NJ
10.2018 - 12.2023
- Denials, Claim Appeals, Insurance Eligibility, Claim follow up, Credentialing, Payer Enrollment, End of month closing financial reports, AR reports, Payment posting, Claim appeals, FQHC billing, Icd 10 coding, HCPCS and CPT, Patient Statements, 340 B Pharmacy Program Audits, Daily charges submission, Conducting financial meetings, Mail, Ongoing training for provider, receptionist, and billing staff, Research for meetings, Covid HRSA programs, Family Medicine Billing, Mental Health Billing, Wraparound Reports, HRSA, Policy and Procedures, Sliding Fee Program, PE (Presumptive Eligibility)
Receptionist / Registration Clerk
Project H.O.P.E Inc
Camden, NJ
09.2017 - 10.2018
- Patient Registration, Insurance Eligibility and Benefits, Patient Check In, Referrals and Pre-cert, and Procedure Prior Authorizations, Behavioral Health Registration and Scheduling, Medical Records Management
- 340B, Spanish Translator
Call Center Clerk
Project H.O.PE Inc
Camden, NJ
01.2016 - 09.2017
- Scheduling appointments for Primary Doctors, Social Workers and Drugs and Alcohol Counselors, Answering phones, Insurance Referrals, Procedure Prior Authorization in Network and Out of Network, Medical Records Management, Eligibility and Benefits, EHS knowledge, Navinet Knowledge, NJMMSand Availity
Office Manager
Vital Medical Care
Moorestown, NJ
08.2013 - 10.2015
- Medical Records Management, Patient Scheduling, Filing Document, Eligibility and Benefits, Phone Messages, Assist in Office Procedure, DME orders, Labs and Imaging Orders, Patient Care, Navinet Knowledge, Insurance Claims, Submitting corrected claims, Checking Benefit Coverage for Patient Supplies, EMR Knowledge, Patient Vitals, Supervise Employee, Inventory of Medication, Patient Payments Copay and Past Due Amounts, Insurance Referrals, Prior Authorization Medication and Procedure
Education
Certification - Health Claims Specialist
Harris School of Business
Cherry Hill, NJDiploma - Medical Assistant
Harris School of Business
Cherry Hill, NJSkills
- 75 WPM
- CPT
- DATA ENTRY
- DATA MANAGEMENT
- HIPPA
- Billing
- Excel
- Medical Terminology
- Receptionist
- Scheduling
- Time Management
- Filing
- Outlook
- Organizational Skills
- English
- Spanish Languages
- Spanish - Expert
- English - Expert
Certification
- National Certified Insurance Coding Specialist
- Community Health Credentialing Specialist
Additionalinformation - Professionalskills
- ICD10- CPT - HCPCS Insurance Verification HIPPA/Patient Confidentiality
- Medical Terminology Data Entry Microsoft Office Application
- Data Management Organization Skills Keyboarding 75 WPM
- Fluent Communication Self-Motivated Goal Oriented
- Staff/Team Administration Strong Interpersonal Skills Dependable
Languages
- Spanish, Expert
- English, Expert
Awards
- NJPCA Healthcare Hero, 10/01/22
- NJPCA TrainUp, 10/01/18
Languages
Spanish
Professional
English
Professional
Accomplishments
- NJPCA Healthcare Hero
- NJPCA Train Up
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Senior Medical Billing Specialist
Project H.O.P.E., Inc
12.2023 - Current
Medical Billing Specialist
Project H.O.P.E., Inc
10.2018 - 12.2023
Receptionist / Registration Clerk
Project H.O.P.E Inc
09.2017 - 10.2018
Call Center Clerk
Project H.O.PE Inc
01.2016 - 09.2017
Office Manager
Vital Medical Care
08.2013 - 10.2015
Certification - Health Claims Specialist
Harris School of Business
Diploma - Medical Assistant
Harris School of Business
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