Yolanda Delgado

Corrects financial and demographic information that has been inaccurate entered in EPIC.

Performs various functions to complete and expedite the billing process, including: Reviews and submits hospital and or physician claim forms to insurance companies via electronic or manual processes and facilitates special billing fir split claims, ancillary charges, interim bills, etc.

Resolves claim edits to facilitate timely billing and reimbursement.

Performs follow up with insurance companies to obtain claim status, and payment information and resolve claim discrepancies.

Submits itemize billing, medical records, and corrected claim as needed.

Reviews remittance advice to ensure proper reimbursement.

Accesses external payer policies, claim investigation and claim dispute.

Reviews accounts and coordinates with appropriate departments on accounts requiring recertification, preauthorization, referral forms and other requirements related to manage care.

Makes written and/or verbal inquiries to third party payers to reconcile patients accounts. Follow up on accounts until zero balance ir turned over collection.

Reviews third party payers payments and investigates account not paid as expected. Takes appropriate corrective action to include follow up, rebilling, and or adjustment of contractual allowances.

Answers all inquiries regarding patients accounts.

• Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
• Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
• Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
• Responded to customer requests for products, services, and company information.

• Assisted employees with inquiries regarding their paychecks, deductions, and other related issues, providing clear and concise communication.
• Provided customer service to employees regarding payroll inquiries and issues.
• Performed calculations in overtime, vacation, and sick hours to provide accurate data to payroll processing database.
• Verified and submitted timekeeping information for accurate and efficient payroll processing.