Alma Arce
Fremont
Summary
Results-driven individual with a solid track record in delivering quality work. Experience in fast-paced environments and adaptable to last-minute changes. Thrives under pressure and consistently earns high marks for work quality and speed.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Medical Scheduler
On Lok PACE Center
08.2024 - 08.2025
- Obtained prior authorizations for medical procedures and services
- Coordinated patient referral appointments to ensure timely access to care.
- Provided administrative support to clinical and office teams, facilitating smooth operations and patient flow.
- Delivered exceptional customer service to patients and healthcare providers.
Patient Account Representative
Washington Hospital Healthcare Systems
11.2022 - 04.2024
- Coordinated with medical insurance providers to verify coverage of patient treatments, ensuring patients received necessary care.
- Developed personalized payment plans for patients based on monthly income and financial obligations to facilitate timely payments.
- Maintained patient records, detailing treatments and diagnoses, while updating payment and medical insurance information to ensure accuracy.
- Identified medical coding mistakes, typing errors, as well as patient underpayments or overpayments and rectified them accordingly.
- Handled financial transactions for patient payments and refunds at the front desk.
Care Transition Community Coordinator
Tiburcio Vasquez Health Center
10.2020 - 08.2022
- Monitored delivery of care by completing patient rounds, documenting care, and maintaining communication for transfer/discharge plans.
- Inspired staff to uphold high standards of patient care through ongoing support and communication.
- Educated patients and their families on the care plan, and provided details related to treatments, procedures, medications, and continued care requirements.
- Created interdisciplinary management tools by leading meetings and coordinating information on care requirements.
- Assessed care outcomes with interdisciplinary team by analyzing intervention effectiveness and facilitating discussions.
Workers Compensation Medical Billing Specialist
National Labs
07.2019 - 07.2020
- Managed worker's compensation insurance and commercial underpayments, correspondence, appeals and aging.
- Reviewed claims for errors, correcting discrepancies to facilitate accurate processing and reimbursement.
- Appealed claims that were incorrectly processed for additional benefits.
- Managed billing, collections, and reimbursement for specific patient accounts.
- Reviewed each account on the status aging report; if no response, presented the account for collections/lien to the Billing Manager for collection decisions.
- Participated in billing office meetings to discuss updates and address issues.
Billing Technician II
Alameda Health System, Fairmont Hospital
09.2018 - 04.2019
- Resolved insurance claims through proactive communication and collaboration with company representatives.
- Coordinated collection activities for past-due patient accounts, enhancing recovery efforts.
- Helped patients set up payment plans and complete applications for medical appointments and procedures.
- Maintained current and accurate notes for patient records in facility EMR.
- Maintained current and accurate notes for patient records in facility EMR.
Billing Specialist
Turner Eye Institute
05.2018 - 08.2018
- Interpreted program billing policies and regulations to ensure adherence and minimize discrepancies.
- Input accurate data into various computer systems, contributing to timely and precise billing processes.
- Prepared financial reports and maintained ledgers and journals, ensuring accuracy and compliance with financial regulations.
- Executed tasks autonomously in a fast-paced environment.
- Comprehended and adhered to instructions from supervisors.
- Read and interpreted procedure manuals.
Billing Specialist
Premier Eyecare
09.2017 - 02.2018
- Filed appeals for denied or underpaid claims, ensuring timely resolution.
- Secured authorization for HMO plans and surgeries, facilitating patient access to necessary care.
- Corrected missing or incorrect modifiers to maintain billing accuracy and compliance.
- Posted patient and insurance payments daily.
- Scheduled, rescheduled, and canceled appointments for patients.
- Obtained eligibility for upcoming appointments up to a week ahead.
Workers Compensation Medical Biller
Getix Health
07.2015 - 03.2017
- Assisted patients in initiating worker's compensation cases to facilitate timely claims processing.
- Reviewed claim denials and payer requirements for corrective action.
- Identified account discrepancies and issues inhibiting claim payments.
- Followed up on and collected outstanding balances and receivables to ensure financial accuracy.
- Collaborated with front office staff to gather necessary information for efficient claims processing.
Education
Medical Billing and Coding Certificate -
Carrington College
San Leandro, CASpanish Bachelor’s Undergraduate Degree -
California State University East Bay
Hayward, CAHigh School Diploma -
Lionel Wilson College Preparatory Academy
OaklandSkills
- Patient scheduling
- Appointment coordination
- Insurance verification
- Prior authorization
- Healthcare reimbursement
- Billing support
- Patient engagement
Languages
English
Native/ Bilingual
Spanish
Native/ Bilingual
Certification
Medical Billing and Coding Certificate
Timeline
Medical Scheduler
On Lok PACE Center
08.2024 - 08.2025
Patient Account Representative
Washington Hospital Healthcare Systems
11.2022 - 04.2024
Care Transition Community Coordinator
Tiburcio Vasquez Health Center
10.2020 - 08.2022
Workers Compensation Medical Billing Specialist
National Labs
07.2019 - 07.2020
Billing Technician II
Alameda Health System, Fairmont Hospital
09.2018 - 04.2019
Billing Specialist
Turner Eye Institute
05.2018 - 08.2018
Billing Specialist
Premier Eyecare
09.2017 - 02.2018
Workers Compensation Medical Biller
Getix Health
07.2015 - 03.2017
Medical Billing and Coding Certificate -
Carrington College
Spanish Bachelor’s Undergraduate Degree -
California State University East Bay
High School Diploma -
Lionel Wilson College Preparatory Academy