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Professional Summary
 Dedicated and reliable Insurance Verification Specialist with excellent insurance document organization and interpretation skills. Experience with all public and private health insurance practices and policies. 
Licenses
Certificate of Competency in Medical Insurance Billing and Coding 

Skill Highlights
  • Knowledge HMO's,PPO's,EPO's,Medicare , Medi-Cal,Third Party
  • HIPAA compliance 
  • Knowledge of In network/Out-of-network
  • Managed care contract knowledge
  • Claims analysis and review specialist
  • Quick learner
  • Personal and professional integrity
  • Patient-oriented
  • MS Word,MS Outlook Excel,Medisoft,Total MD, Office Ally, Allscripts
  • Electronic Medical Record (EMR) software
Professional Experience
Insurance Verification Specialist/ Medical Collector 03/2017 to Current On Line Billing Torrance, CA
  • Efficiently performed insurance verification and Authorizations
  • Submit requested medical documentation to insurance companies
  • Up-to-date with all insurance requirements
  • Maintained and updated insurance information for all patient files.
  • Communicate with patients about their estimated out of pocket payments
  • Appropriately and correctly identified errors and re-filed denied/rejected claims 
  • Meticulously tracked and resolved underpayments
  • Posted charges, payments and adjustments.
  • Carefully prepared, reviewed and submitted patient statements.
  • Ensured timely and accurate charge submission through electronic clearing house. 
  • Submit and follow up on Appeals if necessary
Medical Billing Collection Specialist 11/2015 to 12/2016 Insight Practice Partners Los Angeles, CA
  • Insurance Verification
  • Authorizations
  • Patient Demographics
  • Communicate with payer's
  • Assisted patients with billing issues and reviewed EOB's
  • Maintained aging report to keep payment under 120 days.
  • Consistently meet/exceeded productivity standards
  • Overturned numerous insurance's decisions
  •  Identified EOB errors and re-filed denied/rejected claims 
  • Submitted written Appeals  
ERISA & PPACA Medical Collector Specialist 03/2015 to 11/2015 Acclaim Recovery Management Torrance, CA
  • Interpreting EOB's and Summary Plan Descriptions
  • Following up on Appeals Claim status
  • Third Party Vendor negotiations
Personal Injury Biller/Medical Records 09/2012 to 03/2014 Medical Plaza of San Pedro Torrance, CA
  •  Chiropractic and Physical Therapy Billing.
  • Direct contact with Attorneys
  • Management of Subpoena's
Education and Training
Certificate: Medical Billing and Coding 2012 Southern California Regional Occupational Center Torrance, CA

This resume is created in 7 minutes.
Summary of Qualifications
  • Billingual; Spanish/English
  • Capable of working independently and within a team while fostering postive relationships with managment and peers
  • Familiarity with Medicare Advantage, commercial insurance, Medicare and Worker's Compensation claims
  • Maintains strict confidentiality
  • Strong work ethic
  • Excellent Computer and telephone communication skills
  • Proficient with Medi-Tech, HPF, Electronic Medical Records (EMR) Web PT, Medi-Soft, Micro MD, Egnyte, Eams Case Search,
  • CPT and HCPCS coding
  • Orthopedic Surgery, Physical Therapy, In/Out Patient Surgery, DME
  • Billing and Collections for Facility and Professional

  • Objective
    To secure an employment opportunity that offers professional experience and growth
    Professional Experience
    Medical Collector - Account Analyst
    May 2017 to Current
    Prime HealthCare, LLC Ontario, CA
    • Mangage and collect on Medicare Advantage, Commercial Health plans outstanding Hospital/Facility claims.
    • Complete monthly ATB reports on outstanding hospital claims 
    • Prepare and conduct retro-authorization approval appeals for non certified inpatient admission claims
    • Review EOB/RA's, carefully price claims, review contracts and or utilize pricing tools to confirm claims processed and paid accordingly.
    • Submit accurate appeals on denied non medically necessary claims and or underpayments 
    • Confirm via DOFR correct IPA Medical Group or Capitated Hospital financial responsibility of non paid claims
    • Provide weekly reporting to management of request for adjustments and cash log of overturned accounts
    Medical Collector
    July 2015 to May 2017
    R X Transcription & Coding LLC Ontario, CA
    • Manage and collect on commercial outstanding claims for several out-patient surgery centers
    • Submitted valid appeals on denied and or underpaid claims
    • Collected on outstanding and aging patient balance responsibility accounts, commercial and self pay
    • Negotiate and resolve claims with outsourced health plan pricing departments
    • Carefully prepared, reviewed and submitted accurate patient statements
    • Follow up with numerous health plans regarding claim and or appeal status over the phone and online.


    Workers Compensation Medical Collector
    May 2014 to July 2015
    MBC Systems LLC Santa Ana, Ca
    • Manage Workers Compensation for 5 physical therapy facilities
    • Negotiate/Settle outstanding liens with defense attorneys, claims examiner and or personal injury claims
    • Prepare and organize exhibits for WACB lien hearings
    • Re-Bill/Correct insurance claims and or appeals for denied or underpaid claims
    • Collect commercial insurance and Medicare outstanding patient balances
    Medical Biller/Collector
    February 2007 to March 2014
    Medical Center for Bone & Joint Disorders Upland, Ca.
    • Submitted CMS 1500 claims for commercial and workers compensation insurances for physical therapy services
    • Collected on professional and physical therapy claims
    • Maintained timely follow up with patients on outstanding balances for copays, deductibles or self pay accounts
    • Submitted necessary appeals on denied or underpaid claims
    • Coordinated treatment authorization request for extended physical therapy treatment, MRI's, CT Scans and DME.
    Education
    High School Diploma : 1994 La Habra HIgh School La Habra, Ca, USA
    Associate of Arts : General Studies, 1998 Cuesta College San Luis Obispo San Luis Obispo, Ca
    Professional Summary
    Enthusiastic and energetic with excellent people skills and strong leadership work ethic. Great communicator and extensive knowledge of medical terminology.

    This resume is created in 7 minutes.
    Summary

    Knowledgeable and professional Receptionist adept at administrative support and customer service. 2 years' experience managing company reputation with customers. Strong planning, problem solving and communication skills with an efficient approach.

    Skills
    • Strong organizational skills
    • Active listening skills
    • Energetic work attitude
    • Telephone inquiries specialist
    • Conflict resolution proficiency
    • Customer service management expertise
    Work Experience
    10/2016 to Current
    Lead Collector Pacific Credit Services Fairfield, CA

    I am currently working at this job. I am on the phones all day proving the best customer service. We call consumers on the phone and work with them to find solutions to their debt. 

    12/2014 to 07/2015
    Cashier The Habit Vacaville, CA

    This was a fast food environment, it was my first job. I was a cashier, I decided to leave because this was only a part time job.

    07/2015 to 11/2016
    RECEPTIONIST, OWNER LOYALTY MANAGER,CASHIER WISE AUTO GROUP VACAVILLE, CA

    I did a little bit of everything. Started off as a service cashier/receptionist than became a manager which was a lot of clerical work. I spoke to a lot of customers and got feedback from their visit to the dealership and created files to submit feedback to my manager.

    Education
    High School Diploma Vacaville High School Vacaville, CA
    Skills

    I am bilingual I speak English and Spanish.

    This resume is created in 7 minutes.
    Professional Summary

    Sports and exercise science graduate with academic experience in physical therapy, biology, and other sciences. Strengths include professionalism, attention to detail, integrity, and making patients feel comfortable and knowledgable throughout their acquired treatment. 

    Skills
    • Outstanding interpersonal skills
    • Specialization in sports injuries and therapy
    • Team leadership skills
    • Patient-focused attitude
    • Microsoft Office proficiency

    • Organizational skills
    • Computer proficient
    • Empathetic
    • Extremely detail-oriented
    • Quick learner
    • Superior written skills
    Work History
    Medical Collector, 04/2015 to 08/2015
    National Recovery Management Corporation Coral Springs, FL
    • Reviewed and updated client correspondence files and scheduling database.
    • Contacted persons with medical debt in attempt to pay it.
    • Assisted with receptionist duties, file organization and strategy development.
    • Entered numerical data into databases in a timely and accurate manner.
    • Scanned documentation and entered into the database.
    Physical Therapy Unit Intern, 05/2016 to 08/2016
    Gelb Sports Medicine & Orthopaedic Center Boca Raton, Florida, United States
    • Facilitated outpatient physical therapy for patients with knee and hip replacements, chronic pain and balance disorders.
    • Managed and organized the daily schedules of physical therapy assistants and patients.
    • Aided and counseled patients adjusting to permanent physical disabilities.
    • Monitored and recorded patient progress in response to therapy.
    • Planned individually-designed treatment programs to restore, maintain and improve physical functioning, alleviate pain and prevent disability.
    Intern, 06/2015 to 08/2015
    Super Smiles Pediatric Dentistry & Family Orthodontics Plantation Plantation, FL
    • Prepared rooms for patient treatment.
    • Assisted dental assistants by passing instruments when needed. 
    • Filed paperwork and scheduled patient visits. 
    • Warmly greeted patients and helped them fill out intake and consent forms.
    Intern, 05/2017 to 07/2017
    Neurology Offices of South Florida, LLC Boca Raton, Florida
    • Organized envelopes, postage and mail correspondence for all patients. 
    • Scheduled and made appointments for multiple doctors. 
    • Received and placed telephone calls to patients regarding appointments and scheduling. 
    • Worked closely with office staff to maintain a positive atmosphere for patients. 
    Education
    Bachelor of Science: Sports and Exercise Science, Current
    University of Central Florida - Orlando, FL
    • Coursework in Health Sciences and Occupational Therapy
    Accomplishments

    College of Education and Human Performance President's List- Fall 2014
    College of Education and Human Performance Dean's List- Spring 2015
    Secretary- Sigma Chi Fraternity

    Historian- Sigma Chi Fraternity 

    Affiliations

    UCF Splash Pals

    Sigma Chi Fraternity 

    Certifications

    Cardiopulmonary Resuscitation Certified (CPR)

    Adobe Photoshop Certified