ZULEMA PLACENSIO LANE
Pueblo West,CO
Summary
Reliable Medical Biller with over 13 years of coding and medical terminology knowledge. Polished and hardworking performer with background overseeing accounts and handling records management tasks. Team-oriented person with great decision-making skills.
Overview
11
11
years of professional experience
Work History
Client Analyst
MSN Managment Service Network
05.2018 - Current
- Reviewed billing problems, researched issues, and resolved concerns.
- Trained and mentored staff on procedures, compliance requirements, and collections techniques.
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
- Performed billing, collection, and reporting functions.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Located errors and promptly refiled rejected claims.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Identified and resolved patient billing and payment issues.
- Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
- Proved successful working within tight deadlines and a fast-paced environment.
- Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
- Worked well in a team setting, providing support and guidance.
- Developed and maintained courteous and effective working relationships.
- Strengthened communication skills through regular interactions with others.
Patient Service Representative & Assistant Manager
MSN Managment Service Network
06.2012 - 05.2018
- Provided exceptional customer service to patients, and fellow team mates answering questions and addressing concerns.
- Verified insurance eligibility and coverage for patients.
- Entered patient demographic and insurance data into electronic medical record system.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Built and maintained positive working relationships with patients and staff.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Managed and motivated employees to be productive and engaged in work.
- Maintained professional, organized, and safe environment for employees and patrons.
- Accomplished multiple tasks within established timeframes.
- Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
- Maximized performance by monitoring daily activities and mentoring team members.
- Cross-trained existing employees to maximize team agility and performance.
Education
No Degree - General
Western Nebraska Community College
Scottsbluff, NEHigh School Diploma -
Mitchell High School
Mitchell, NE05.1990
Skills
- Inquiry Requests
- Electronic Health Records Systems ie EPIC, MEDITECH
- Operations Support ie IMAGINE
- Reconciling Accounts
- Administration and Management
- Correct Errors
- CMS-1500 Billing Forms
- EZClaim
- Access Software
- Billing Statement Management
- Microsoft Office
- Customer Experience
- Process Monitoring
- Managing Delinquent Accounts
- ICD-10
- Records Maintenance
- Data Analysis
- Billing Codes
- Obtaining Authorizations
- Revenue Operations
- Medical Billing
- HIPAA Compliance
- Account Posting
- Medical Claims Submission
- Physician Interaction
- System Updates
- Workers' Compensation Knowledge
- Benefits Verifications
Additional Information
I have extensive knowledge of working with major Insurance payors below;
Medicare & RR Medicare,
Medicaid for the states of CA, CO, WA, HI, AZ, & NV.
TRICARE all regions
Most commercial payors i.e BCBS, UHC, CIGNA, AETNA, HUMANA
IPA's
Timeline
Client Analyst
MSN Managment Service Network
05.2018 - Current
Patient Service Representative & Assistant Manager
MSN Managment Service Network
06.2012 - 05.2018
No Degree - General
Western Nebraska Community College
High School Diploma -
Mitchell High School
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