Medical Biller

I am a person who always finishes the tasks given by the employer. I made sure that every task is prioritized accordingly and the projects assigned are well-organized and established.

Revenue Cycle Manager - Behavioral Health Practice in California - California

(2024-05)

• Checking benefits and eligibility of the patient by calling insurance companies to make sure that the insurance will cover the services rendered.
• Checking denials of the claims submitted to the insurance companies
• Submitting claims electronically via EHR or insurance portals; or submitting manually via paper claims
• Calling insurance companies to have the claims sent back for review for incorrectly processed claims
• Submitting appeals if necessary
• Transferring the balance to the patient's responsibility if the claims were processed and paid towards the deductible or the claims were denied due to termed insurance coverage.

Revenue Cycle Specialist - Tactical Back Office - Acelleron Medical Products (DME Provider)

(2024-02 - 2024-04)

• Checked benefits and eligibility of the patients by calling insurance companies to make sure that insurance will cover the services rendered
• Submitted claims electronically via insurance portal for the claims to be processed
• Checked general claims status of the submitted claims if there's a need to make some changes or corrections based on the denial reason
• Checked and resolved claims denial by calling the insurance companies for the claims to progress
• Submitted / Filed an appeal for the denied claims to get paid
• Corrected CPT codes and its modifiers
• Dropped the balance to the patient's responsibility if the primary and/or secondary insurance were not going to cover the procedure

Insurance Verifier / Revenue Cycle Specialist - Tactical Back Office - The Compression Store (DME Provider)

(2022-07 - 2024-02)

• Checked benefits and eligibility of the patients by calling insurance companies to make sure that the insurance will cover the services rendered
• Submitted claims electronically using both EMR and insurance portal
• Checked general claim status of the submitted claims and if there's a need to make some changes or corrections based on the denial reason
• Checked and resolved claims denial by calling the insurance companies for the claims to progress

Patient Coordinator - Omega Healthcare (ATI Physical Therapy and Ascend Medical)

(2020-07 - 2022-07)

• Scheduled/canceled/amended the patient's appointment to fulfill their requests
• Checked the insurance cards and photos that the patients submitted in order to see if they will be covered for services rendered

Different technical roles not related to healthcare - Various Companies

(2010-07 - 2020-06)

Bachelor of Science - Computer Science - Our Lady of Fatima University (2006 - 2010)