Edgar Romero

Performed patient revenue cycle and customer care activities in accordance with applicable Federal, State and local standards, guidelines and regulations, and in adherence to UCSD Health customer service standards. Responsibilities include but are not limited to customer service, patient billing and/or patient account balance collection activities associated with the hospital and professional revenue cycle.

Complete knowledge of private insurance, Government programs, and uninsured patient billing procedures. Responsible for updating patient demographics and insurance, and verifying accuracy of payments and any corrections necessary.

Assisting patients with understanding of explanations of benefits. Rebilling claims to insurance, and submitting claims for coding review and insurance review.

Call center environment answering calls, patients, insurances, and all third party callers.

Resolved patient complaints with empathy, resulting in increased loyalty and repeat business.

Performed full range of billing duties, within the revenue cycle from claim generation to final payment disposition. Updating patient demographics, maintaining patient accounts up to date

with most recent active insurance policy, Submitting claims for review coding & insurance. Collecting co-payments, pre-payments for scheduled procedures. Assisting patients with understanding and getting familiar with insurance explanation of benefits. Responsible for documenting patients accounts with a recap and outcome of account billing issues and or any patient inquiry.

Responsible for all imaging scheduling, CT-Scans, MRI, Ultrasounds, Annual screening mammograms, and diagnostic mammograms, QCT and DXA bone scans. Heavy phone customer service, working closely with outside referrals and healthcare practices, such as internal medicine, sports medicine, Oncology private offices, workers comp adjusters, and hospitals. Retrieving medical orders electronically, entering insurance info and submitting for authorization approval. Average incoming calls per day to schedule per line 100+, also doing outbound calling to schedule exams, working closely with workers comp cases and adjusters, reviewing injury records and collecting all clinical notes regarding injury for proper scheduling.

Phone scheduler heavy customer service scheduling for the, Ear Nose and Throat department. Scheduling nasal trauma/fractures, tongue tied clipping, hearing loss consults, sleep apnea consults, emergency add on such as E.R. Referrals for foreign body in ear, Monitoring physicians schedules closely, responsible to schedule under appropriate time slot, requesting approval scheduling from triage nurse and department supervisor. Confirming appointments, sending physicians electronic messages through Epic Systems to get approval for overbooking or adding patients for same date of service.

Sending electronic messages through Microsoft Outlook to department referral coordinators to verify eligibility and to obtain referral or authorization for future consults or return visits, also for same day on appointments.

Providing executive administrator duties to the Hematology Oncology Office, surgery scheduling

Obtaining authorizations for inpatient admitting, scheduling chemo and infusion treatments.

Filling out disability paper work, coordinating physician's schedule such as blocking and rescheduling patients, releasing lab results and procedure results to pts all within normal range all abnormal results, would to directly to nurse or physician. Calling in and sending prescriptions electronically through different pharmacies and specialty pharmacies. Exchanging emails with physicians and with operations supervisor. Providing excellent phone customer service to all incoming and out coming phone calls.