Experienced, Bilingual Medical Biller
ADRIANA S. HERNANDEZ
3009 W. Claremont St. Phoenix, Arizona 85017
Home#: 602-242-3933 Cell#: 602-872-1156
To obtain a challenging, permanent position in which I can utilize my extensive knowledge of Medical billing and coding abilities to the fullest. I have over 13 years’ experience in the Healthcare field in which that has given me the extensive knowledge and tools to be successful and succeed in medical billing and coding. I am fluently bilingual and I can also read and write in Spanish. My most valuable attribute is that I enjoy challenges. I am a quick learner, self-motivated, organized, detailed, adjust well to change and motivated to growing professionally. I have a natural talent when it comes to working with people in which allows me to quickly identify and solve problems quickly. ____________________________________________________________________________________________________ Qualifications:
Lead Biller/Coder, 10/2011 to 5/2012
Job duties consist of billing Medicare claims for Puerto Rico, appealing denials from Medicare. Reviewing new contracts with insurance companies as the company is just starting out. Answered phones and handle any job tasks needed.
E & A Medical Billing Services
Billing Coordinator, 10/2010 to8/2011
Job duties consisted of billing for eight independent Anesthesiologists. Worked daily in Insurance Queue, claims in review and denied claims. Billed initial claims, to primary insurance and secondary insurance both paper and electronic claims. Appealed denied claims. Checked status of payment on claims, worked aging reports for insurance and patient balances. Review payment proposals from insurance carriers. Called patient’s with past due balances, set up payment plans and if needed forward account to outside Collection agency.
Central Phoenix Obstetrics and Gynecology
Billing/Patient Account Specialist, 4/2007 to 11/2009
Job duties consisted of verifying eligibility and benefits for maternity care and surgical procedures. Spoke with maternity patients and patients having surgical procedures, of their benefits and patient responsibility. Obtained authorizations for maternity care and all surgeries. Coded surgery records and billed claims. Billed claims electronically and paper. Confirmed electronic submitted claims with Zirmed, reviewed rejected claims, corrected errors and resubmitted. Checked status on claims, resubmissions, reviewed denied claims and filed appeals if necessary. Posted all insurance and patient payments, write offs and adjustments. Balanced and prepared for daily deposits. Verified and closed end of day and end of month. Handled all referrals to other providers and authorizations. Called patients regarding balances, set up payment arrangements. Worked with outside Collection agency and followed up monthly on accounts. Followed closely all the patients with AHCCCS, to verify that eligibility was current. Ordered family planning devices and special order injections and obtained authorization if required. Implemented and maintained all insurance online accounts for patient eligibility, benefits and claim status. Handled and resolved all patient calls regarding billing issues and complaints.
Arizona Hand Specialists
Billing Account Specialist, 8/2006 to 4/2007
Job duties consisted of verifying eligibility, benefits and authorizations for scheduled surgeries. Worked closely with schedulers, to ensure that patient would be counseled regarding any patient responsibility. Set up payment plans on coinsurance balances and self-pay patients. Assisted patients on applying for AHCCCS. Coded procedures performed in-office and outpatient and billed claims. Handled billing, resubmissions, denials and appeals for Aetna, AHCCCS plans, Cigna, UHC and Workman’s comp insurances. Responsible for only Spanish speaking patients and accounts.
Dyna Care Home Health
Intake Coordinator, 9/2005 to 8/2006
Job duties consisted of processing all incoming referrals from doctor’s offices, hospitals, skilled nursing facilities ordering home health services from skilled nursing, physical/occupational/speech therapy and home health aides. Call insurances to verify eligibility and home health benefits. Obtain initial authorizations and re-authorizations. Data entered all patient demographics and insurance information. Scheduled new cases to be opened and confirmed with ordering physician. Reviewed and code Oasis (Medicare) Start of Care, Re-Opening and Discharge super bills and data entered Home Health Certificates. Ordered wound care, ostomy supplies and durable medical equipment. Followed up on hospitalized patients and scheduled for follow up visit from hospital discharge.
Rehab Intake Coordinator, 11/2004 to 8/2005
Job duties consisted of incoming referrals from doctor’s offices and skilled nursing facilities for custom ordered manual or powered wheelchairs, scooters and special ordered equipment. Verified eligibility and DME benefits and obtained authorizations. I fee scheduled pricing according to insurance contracts for equipment. Data entered patient demographics, insurance information and equipment tickets. Schedule all appointments for the Seating Specialist and Technician. Code and billed the equipment and generated the Medicare Certificate of Medical Necessity for the ordering physician and followed up through completion to confirm if patient was eligible under Medicare regulations. Follow up with ordering physicians when certification periods were ending and would process re-certifications to ensure updated patient eligibility. Processed and ordered all equipment and inventory.
Arizona Home Care
Intake Coordinator, 1/2004 to 11/2004
Job duties consisted of incoming referrals for home care and infusion services, verifying insurance benefits, obtaining authorizations, data entry, coding and billing. Scheduling cases to be opened with nurse and patient, coordinating delivery of supplies and medication, handled denials, appeals and maintaining authorizations up to date.
Healthcare Financial Staffing
Medical Billing/Payment Poster, 11/2001 to 11/2003
Job duties consisted of temporary job assignments to clients- billing and payment posting for Maryvale Hospital, collections and denials for Phoenix Memorial Hospital, billing and customer service for Coram Healthcare, billing for dermatology physician.
East & Associates
Data Entry/Billing, 10/2000 to 8/2001
Job duties consisted of data entry of patient demographics, insurance verification, coding, submitted initial claim for independent anesthesiologists, credentialing, handled all Spanish speaking patient accounts and collections ____________________________________________________________________________________________________. Education:
Present - Rio Salado College- Healthcare Administration – Substance Abuse Counselor
2005 - Gateway Community College - Medical Billing/Coding
1996 - Mountain Pointe High School - General Education Diploma ____________________________________________________________________________________________________ Skills: Billing Coding Data Entry Payment Posting Collections Reports Word Outlook Excel EMDS Termlite Medex Medical Mgr Mesta Med MediSoft Medifax Citrix ACIS TIMS Passport HAVEN Great Plains PCN 10key touch/sight 10,000kph 40wpm _______________________________________________________________________________________________________*References Available Upon Request*