Ana Rodriguez
2272 Orchard St Apt C Springdale
Summary
To obtain a position in a company where I can utilize my skills and knowledge for the welfare of the company.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Medical Biller II
Ideal Option (Remote)
03.2021 - Current
- Review and appeal unpaid and denied claims
- Use coded data to produce and submit claims to insurance companies
- Ensure weekly, monthly, and quarterly department goals are met
- ECW and multiple payer portals
- Checks eligibility and benefits verification for treatments, hospitalizations, and procedures
- Review patient bills for accuracy and completeness and obtain any missing information
- Prepares, review, and transmits claims using billing software, including electronic and paper claim processing
- Follow up on unpaid claims within standard billing cycle timeframe
- Calls insurance companies regarding any discrepancy in payments if necessary
- Bill secondary or tertiary insurances.
Billing Specialist/ Assistant Office Manager
Pain Management & Rehabilitation Consultants
06.2020 - 03.2021
- -Obtain authorizations for pain injection procedures
- -Check eligibility and benefits for all procedures, and regular appointments
- -Post efts, work denials, rejections, and appeals
- -Work the accounts receivable report
- -Interview and hire new employees
- -Responsible for administration side of a medical office
- -After 2 months I was promoted to assistant office manager, in one month I had brought in more revenue by working the A/R report
- Also, I implemented patient payment agreements, so the office revenue increased.
Billing Specialist
Nwa Urology Associates
02.2019 - 05.2020
- -Obtaining referrals and pre-authorizations as required for procedures
- -Checking eligibility and benefits verification for treatments, hospitalizations, and procedures
- -Reviewing patient bills for accuracy and completeness, and obtaining any missing information
- -Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing
- -Following up on unpaid claims within standard billing cycle timeframe
- -Checking each insurance payment for accuracy and compliance with contract discount
- -Calling insurance companies regarding any discrepancy in payments if necessary
- -Identifying and billing secondary or tertiary insurances
- -Reviewing accounts for insurance of patient follow-up
- -Researching and appealing denied claims
- -Answering all patient or insurance telephone inquiries pertaining to assigned accounts
- -Setting up patient payment plans and work collection accounts
- -Updating cash spreadsheets, and running collection reports.
Patient Financial Services Representative/ Medical Biller
Community Clinic
02.2010 - 02.2019
- Prepared and submitted medical and dental claims to Medicaid, Medicare, commercial insurance and private pay patient accounts
- Analyzed rejected claims, correct errors, and resubmit claims to payer for payment
- Updated information in software on patient accounts when new information comes available
- Posted reimbursement checks in software as received
- Analyzed denied claims, submit corrected claims when necessary
- Work with third party payers on billing problems, denials and requests for information
- Communicated with patients regarding issues affecting payment such as coordination of benefits, third party payers, Medicare replacement plans, and primary care physicians
- Research outstanding claims, correct errors, handled patient billing complaints
- Worked the Accounts Receivable report.
Education
High school diploma -
Springdale High School
Skills
- Microsoft
- ECW
- Nextgen
- Greenway Prime Suites
- Cerner
- Excel
- Medical Records
- Translation
- Insurance Verification
- EMR Systems
- Accounts Receivable
- Hospital Experience
- Medical Scheduling
- Medical Office Experience
- Medical Terminology
- CPT Coding
- Leadership
- Medical billing
- ICD-10
- Accounting
- Clerical Experience
- EClinicalWorks
- Medical receptionist
- Anatomy knowledge
- Preauthorization (8 years)
- Management
Certification
- Medical Terminology, 05/01/22, Present
- Anatomy, 05/01/22, Present
Languages
English
Full Professional
Spanish
Full Professional
Timeline
Medical Biller II
Ideal Option (Remote)
03.2021 - Current
Billing Specialist/ Assistant Office Manager
Pain Management & Rehabilitation Consultants
06.2020 - 03.2021
Billing Specialist
Nwa Urology Associates
02.2019 - 05.2020
Patient Financial Services Representative/ Medical Biller
Community Clinic
02.2010 - 02.2019
High school diploma -
Springdale High School
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