Alexis Fedelin
San Jose
Summary
Organized Medical Biller thoroughly versed in medical coding and HIPAA requirements. Personable professional with several years of hands-on experience claiming refunds, reviewing claims, and maintaining billing reports. Accommodating and helpful team player proficient in job-related billing software.
Overview
11
11
years of professional experience
Work History
Medical Billing Specialist
California Skin Institute
San Jose
10.2019 - Current
- Assisted in billing and coding medical services using ICD-10, CPT, and HCPCS codes to ensure accurate billing.
- Performed quality assurance audits on submitted claims ensuring that they met industry standards.
- Checked claims coding for accuracy with ICD-10 standards.
- Applied HIPAA privacy and security regulations while handling patient information.
- Monitored customer account details for non-payments, delayed payments, and other irregularities.
- Accurately coded diagnostics and prepared billing statements for patients.
- Created and processed claims to third-party payers using specific coding guidelines.
- Answered customer questions to maintain high satisfaction levels.
- Coordinated communications between patients, billing personnel and insurance carriers.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Worked closely with clinical staff to ensure accurate coding practices were followed.
- Performed quality control of data entry system to verify proper posting of claims and payments.
- Performed insurance verification, pre-certification and pre-authorization.
- Assessed billing statements for correct diagnostic codes and identified problems with coding.
- Applied payments, adjustments, and denials into medical manager system.
- Provided customer service support to patients who had questions about their bills or payments due.
Patient Care Representative
Silicon Valley Medical Development
Mountain View
05.2021 - 02.2022
- Registered patients and updates to patient accounts to record demographics, insurance accuracy and eligibility, contact information, and authorizations.
- Verified insurance coverage for all visits to ensure accurate billing procedures were followed.
- Maintained updated knowledge of HIPAA regulations related to the release of confidential medical information.
- Collaborated with clinical and administrative staff to meet patient needs.
- Received and routed care team messages and documents to appropriate staff.
- Greeted patients upon arrival and maintained a clean reception area for visitors.
- Processed payments from patients using cash registers or computer software programs.
- Answered incoming calls from patients and other healthcare professionals to answer questions or provide information.
- Scheduled evaluations and procedures for patients.
- Performed basic clerical duties such as photocopying documents and filing papers.
Concierge Lead Associate
VillaSport Athletic Club And Spa
San Jose
06.2017 - 10.2019
- Provide assistance to the Member Services Director with consistent quality service, accurate information regarding all areas of club operations, and monitor Member Services desk policies and procedures.
- Responsible for any updates on all member accounts regarding billing information, adding and removing members, cancellation requests, etc.
- Answered multi-line telephone with polite tone of voice to provide general information and answer inquiries.
- Maintained confidentiality of guest information and transactions.
- Acknowledged and greeted guests entering or leaving building, promoting pleasant environment.
Guest Service Representative
Extended Stay America Hotel
San Jose
11.2014 - 10.2017
- Assisted guests with check-ins and check-outs in a timely manner.
- Delivered exceptional service to every customer through active engagement, effective listening and well-developed interpersonal skills.
- Performed daily cashiering duties including balancing accounts at end of shift.
- Responded promptly to inquiries regarding availability of rooms and rates.
- Promoted high level of guest satisfaction through genuine, enthusiastic and friendly interactions.
- Greeted guests and provided information regarding hotel services, amenities, and local attractions.
- Maintained client accounts by obtaining, recording and updating personal and financial information.
- Inspected guest rooms prior to check-in to ensure they met quality standards.
Education
High School Diploma -
Piedmont Hills High School
San Jose, CA06-2014
Skills
- Medical billing
- Claims processing
- Insurance verification
- Data entry
- Quality assurance
- Customer service
- Patient communication
- Problem solving
- Time management
- Claim submission
- Files and records management
- HIPAA compliance
- ICD-10 proficiency
- Quality-oriented team player
- CPT knowledge
- Proficiency in Nextech and EPIC software
- Work prioritization
- Multitasking and organization
References
References available upon request.
Timeline
Patient Care Representative
Silicon Valley Medical Development
05.2021 - 02.2022
Medical Billing Specialist
California Skin Institute
10.2019 - Current
Concierge Lead Associate
VillaSport Athletic Club And Spa
06.2017 - 10.2019
Guest Service Representative
Extended Stay America Hotel
11.2014 - 10.2017
High School Diploma -
Piedmont Hills High School