Professional Experience
Medical Billing Specialist 2008-Present
Las Vegas Kidney Clinic: Las Vegas, NV
• Daily duties include: abstracting patient medical information from patient’s flow sheet, entering all charges in preparing claims, posting charges into accounts receivable, cleaning-up denied claims and resubmitting them, and keeping a monthly Census Spread Sheet for Network 14.
• Responsible for balancing medication, treatments, and absences. Scheduled patients for our Chronic Kidney Disease clinic (Red Rock Renal Care).
• Managed all back office duties including: verifying new patient insurance eligibility and coordination of benefits, and CPT/ICD-9 coding. Completed preauthorization of Medications, Diagnostic Physician orders, Renal Ultra sound, CT scan and certain Labs that required additional Diagnosis.

Medical Necessity Representative 04/2006-09/2008
United West Labs: Santa Anita, CA
• Verify for medical necessity for all Medicare requisition also verifying ICD-9 Codes to make sure that Medicare covers tests. Checking Status for Medi-Cal and Medicare eligibility. Helping intake department code all requisitions by its appropriate letter, data entry, and requesting of ICD-codes

Patient Care Representative 06/2004-03/2005
La Care Health Plan: Los Angeles, CA
• Verification of insurance and benefits, Heavy phones, data entry, request medical records and/or procedure reports, referral/authorization, and Heavy volume patient calls.
• Monthly billing analysis, reviewing billing information to ensure that customers are billed in an accurate manner on a monthly basis. Review of customer pricing information as well as the number of users and transactions for which customers are billed.

Medical Coordinator 02/2002-06/2004
Fitness Area Medical Group: Carson, CA
• Handled customer Service and reviewing of EOB’s to appeal and/ or requesting of ICD9 codes, Medical records and/ or office notes. Making sure that when insurances are being billed that the claims goes out with specific detailed information required by the insurance carriers. Worked on accounts that were in collection and worked with patients to assist them in getting their account paid in a timely manner.
• Billed Government Insurances (Tricare, Medi-cal and Medicare, etc) making sure that UPIN numbers are provided along with the Doctor’s provider number. Making sure that specific ICD9 code coincide with CPT procedure codes that are being billed.
• Billed private insurances (Blue Cross/Shield, Aetna and Cigna). Reviewed claims and made sure that necessary information is supplied on the claim. Worked aging report on accounts 60 days to 120 days and over. Called insurances to verify all necessary information needed to process claims.