Billing Specialist - DERMATOLOGY SPECIALISTS, INC
(2024-03 - 2026-03)
- Identified tends in rejections and escalated to manager for proactive resolution
- Reduced claim denial rate by 20% by identifying recurring issues and collaborating with coding staff
- Worked cross functionally with coding, registration, and patient access to resolve billing issues
- Monitored and exceed departmental KPIs including claim turnaround and denial rates
Revenue Cycle Manager / Billing Specialist - Sycuan Casino Resort
(2022-09 - 2023-12)
- Managed the Revenue Cycle team operations, including insurance verification, coding, charge entry, claims submission, collections, and payment posting.
- Served as the expert for verification, coding, billing, and collections processes.
- Developed and enhanced operating policies and procedures to improve quality and efficiency.
- Ensured compliance with coding and billing regulations, relevant healthcare regulations, and data privacy issues (e.g., HIPAA).
- Provided analysis, creating written processes and training others in implementing a cross functional revenue cycle team
Medical Billing Specialist Lead - Cognizant
(2018-07 - 2022-09)
- Charge entry
- Insurance eligibility and verification
- Reviewed and updated patient demographics
- Reviewed and worked various reports including aging, appeals, bad debt, collections
Medical Billing Specialist - San Diego Retina Associates
(2014-08 - 2018-07)
- Worked on accounts receivable (A/R), processed rejected claims, and performed necessary follow-up to ensure successful claim processing.
- Followed up on claims using various systems, including Nextech EHR, TriZetto clearinghouse, and others.
- Prepared and submitted clean claims to insurance companies electronically or by paper.
- Corrected and resubmitted claims to third-party payers when needed.
- Mailed appropriate patient contact letters to resolve outstanding claims.
- Maintained contact with other departments to obtain and analyze patient information for accurate billing documentation.
- Responded to patient inquiries and billing concerns via phone, email, and messaging portals.
- Performed follow-up calls and written correspondence to patients and payers as needed.
