Zaida vargas
SAN JOSE,CA
Summary
Experienced charge entry and billing professional with expertise in Epic, insurance verification, and denial resolution. Known for accurate charge reconciliation, billing compliance, and timely follow-up on appeals, refunds, and patient inquiries.
Overview
1
1
Language
1
1
Certification
13
13
years of professional experience
Work History
Charge entry specialist
El Camino Health
San Jose, CA
07.2025 - Current
- Entered charge details in Epic for El Camino Health patient accounts.
- Entered procedure codes, diagnosis codes and patient information into billing software to facilitate invoicing and account management.
- Reviewed charge slips for billing accuracy and missing documentation.
- Verified insurance eligibility and benefits for services rendered to facilitate accurate billing and reduce denials.
- Performed insurance verification, pre-certification and pre-authorization.
- Worked with clinical and revenue cycle teams to resolve charge edits.
- Compared procedure codes with clinical notes and charge rules.
- Followed up on claims, processed appeals, and managed refunds for overpaid patient accounts, ensuring timely resolution of billing issues. for overpaid accounts patients and payers, answer billing inquiries.
- Responded promptly to inquiries from patients, payers, or other external parties concerning billing issues.
- Advised medical staff on authorization request statuses, enhancing communication and expediting patient care.
Patient Account Representative
Washington Health
Fremont, California
09.2021 - 06.2024
- Reviewed patient accounts to identify and resolve billing and insurance discrepancies, ensuring accurate patient billing.
- Resolved patient billing inquiries using clear, professional communication.
- Collected patient payments and arranged payment plans for outstanding balances.
- Processed insurance claims and corrected claim errors in account systems.
- Updated demographic and insurance information in patient account records.
- Interpreted explanation of benefits and applied adjustments to accounts.
- Verified coverage details with payers and documented account activity.
- Analyzed claims denials from third-party payers to identify solutions for reimbursement, improving claims success rates.
- Submitted appeals on behalf of patients based on research into denied claims.
Implementation Specialist
VERITY MEDICAL FOUNDATION
San Jose, California
09.2013 - 03.2019
- Coordinated onboarding for new practices to ensure seamless integration with Verity Medical Foundation systems.
- Implemented clinic workflows for Verity Medical Foundation across provider teams.
- Configured application settings to align with operational requirements of medical foundation.
- Reviewed accounts for contract payments and adjustments to ensure accuracy and compliance.
- Entered charges into billing system accurately Identified procedures and diagnosis to properly CPT code Performed corrections.
- Submitted claims promptly.
- Verify medical insurance coverage and benefits.
- Answer high volume of calls from patients, staff and physicians.
- Conducted follow-ups on outstanding accounts, Appeals, Refunds for overpaid accounts patients and payers, answered billing inquiries.
Education
Associate of Applied Science - Accounting
Universidad Autonoma De Guerrero
Some College (No Degree) - MEDICAL ASSISTANT
CCOC
San Jose, CASkills
- Insurance verification
- Authorization processing
- Claims processing
- Claims adjudication
- Denial resolution
- Epic charge capture
- CPT coding
- ICD-9 and ICD-10
- Medical billing procedures
- Process payments
- Patient Scheduling
- HIPAA compliance
- Charge reconciliation
- Customer service
Languages
Spanish
Full Professional
Certification
- Medical Assistant
Timeline
Charge entry specialist
El Camino Health
07.2025 - Current
Patient Account Representative
Washington Health
09.2021 - 06.2024
Implementation Specialist
VERITY MEDICAL FOUNDATION
09.2013 - 03.2019
Associate of Applied Science - Accounting
Universidad Autonoma De Guerrero
Some College (No Degree) - MEDICAL ASSISTANT
CCOC