Gabriela Nevarez
San Jacinto,CA
Summary
Dependable worker with knowledge of medical insurance verification, ICD-10 and data entry. Highly organized and self-motivated, with excellent communication and interpersonal skills. Demonstrated ability to prioritize tasks and meet deadlines.
Overview
12
12
years of professional experience
Work History
Patient Financial Services Representative
KPC Global Medical Center
01.2024 - Current
- Managed patient accounts, ensuring accurate billing and timely follow-up.
- Facilitated insurance verification processes to enhance claim approval rates and minimize delays.
- Reduced errors in billing, conducting thorough audits of patient accounts and identifying discrepancies.
- Managed high volume of daily tasks while maintaining attention to detail and accuracy in all areas of responsibility.
- Researched billing errors and discrepancies to initiate corrective action.
Insurance Billing Clerk
County of Riverside
09.2022 - Current
- Verify third-party coverage and Medi-cal eligibility
- Review claim submission for accuracy prior to submitting for payment
- Ensure compliance with applicable state and federal laws governing healthcare billing practices
- Verify patient information to ensure accuracy of insurance claims
- Provide customer service for clients with questions about their bills or insurance coverage
- Collaborated with other departments on resolving billing issues quickly and efficiently
- Reconciled account statements and resolve any discrepancies in a timely manner
- Process inpatient and outpatient claims for services rendered
- Processed insurance claims efficiently, ensuring accurate billing and timely payments.
- Maintained comprehensive records of patient accounts and insurance information.
Medical Insurance Biller
Inland Physicians Billing Services
03.2014 - 09.2022
- Assisted with the preparation of monthly reports for management review
- Managed daily office operation including filing paperwork, entering data into databases
- Maintained accurate records of patient data, insurance payments and other financial information
- Developed expertise in medical insurance billing, including HCPCS, ICD-10
- Identified discrepancies between charges billed and amount paid by insurance carrier
- Performed claims research, appeals and related follow-up using medical system and software
- Contracting/Credentialing
Education
Certified Medical Biller -
Kaplan College
Riverside, CA12.2012
Skills
- ELMR Billing System
- Lytec Software
- Office Ally
- Insurance knowledge
- Medical Terminology
- ICD 10 Coding
- Bilingual
- Medi-cal, Medicare, HMO/PPO
- Explanation of Benefits
- HIPAA compliance
- Teamwork orientation
- Claims processing
Timeline
Patient Financial Services Representative
KPC Global Medical Center
01.2024 - Current
Insurance Billing Clerk
County of Riverside
09.2022 - Current
Medical Insurance Biller
Inland Physicians Billing Services
03.2014 - 09.2022
Certified Medical Biller -
Kaplan College