Kendall Cruz
Murrieta
Summary
Skilled Medical Billing Specialist with background in accurate coding, claims processing, and managing patient accounts. Showcased proficiency in medical software systems, healthcare regulations, and insurance policies. Proven ability to streamline billing procedures, leading to increased productivity and improved revenue cycle management. Known for strong problem-solving skills and commitment to maintaining confidentiality in handling sensitive patient information.
Overview
3
3
years of professional experience
Work History
Medical Billing Specialist (Remote)
Well Coast Medical Corporation
San Francisco
07.2024 - Current
- Processed and submitted insurance claims for therapy, psychiatry, and psychological assessments.
- Verified mental health insurance benefits, including copays, deductibles, and authorization requirements.
- Collaborated with providers to ensure accurate documentation and coding using ICD-10 and CPT codes.
- Managed denied claims by researching payer policies, correcting errors, and resubmitting requests.
- Maintained compliance with HIPAA and privacy regulations in all billing practices.
- Reconciled patient accounts, applying payments from insurance companies and patients.
- Communicated with patients regarding balances, coverage, and billing inquiries confidentially.
- Utilized EMR systems like Charm to generate claims and maintain records.
Medical Biller and Coder
Orthopedic And Sports Medicine
Temecula
03.2024 - 06.2024
- Accurately assigned ICD-10, CPT, and HCPCS codes for orthopedic surgical procedures, physical therapy, and follow-up visits.
- Reviewed operative reports, provider notes, and diagnostic results to ensure appropriate code selection and billing compliance.
- Prepared and submitted claims to Medicare, commercial insurance carriers, and workers’ compensation for high-volume surgical cases.
- Identified and corrected billing discrepancies, or documentation deficiencies to reduce denials and expedite reimbursements.
- Identified and corrected billing discrepancies or documentation deficiencies to reduce denials and expedite reimbursements.
Medical Biller
United Surgery Center
Murrieta
12.2023 - 06.2024
- Processed and submitted claims for surgical and gastrointestinal procedures, including colonoscopies, endoscopies, biopsies, and outpatient surgeries.
- Accurately applied ICD-10, CPT, and HCPCS codes based on operative and procedural documentation.
- Verified insurance eligibility, obtained prior authorizations, and ensured pre-certification requirements were met before procedures.
- Reviewed explanation of benefits (EOBs) and remittance advice to reconcile payments and identify discrepancies.
- Resolved denials and appeals by analyzing payer policies and correcting billing or coding issues.
- Coordinated with surgeons, GI specialists, and schedulers to ensure accurate billing and documentation.
- Maintained compliance with Medicare, Medicaid, and commercial payer guidelines for surgical and GI services.
Medical Biller and Coder
Rancho Family Medical Group
Murrieta
11.2022 - 12.2023
- Submitted accurate claims for a wide range of family medicine and women’s health services, including prenatal care, annual exams, immunizations, and chronic care management.
- Utilized ICD-10, CPT, and HCPCS coding to accurately represent procedures and diagnoses, including obstetric global billing.
- Verified insurance coverage and obtained prior authorizations for ultrasounds, procedures, and specialist referrals.
- Utilized ICD-10, CPT, and HCPCS coding to represent procedures and diagnoses, including obstetric global billing accurately. accurately.tient payments, reconciled accounts, and maintained A/R follow-up.
Medical Biller and Coder Intern
24 Hour Urgent Care -
Temecula
07.2022 - 10.2022
- Gained hands-on experience in the medical billing process including data entry, charge posting, and payment reconciliation.
- Assisted in reviewing patient records and provider notes to support accurate claim submission.
- Observed and supported the submission of insurance claims using ICD-10 and CPT coding guidelines.
- Helped verify patient insurance coverage and authorization requirements.
- Shadowed senior billers to learn denial management, account follow-ups, and appeals processing.
- Provided administrative support including filing, scanning, and maintaining billing records.,
Education
Associate of Science - Medical Billing And Coding
San Joaquin Valley College
Temecula, CA02-2024
Certification - Medical Billing And Coding
San Joaquin Valley College
Temecula, CA11-2022
Bachelor of Science - Health Care Administration
Arizona State University
Tempe, AZSkills
- ICD-10, CPT, and HCPCS Coding
- Insurance Verification (Commercial, Medicare, Medicaid)
- Claims Submission & Processing
- Denial Management & Appeals
- EMR Systems ( Epic, Athena, Charm)
- RCM
- Payment Posting & Reconciliation
- Medical Terminology & Anatomy
- Prior Authorizations & Referrals
- HIPAA Compliance
- Medical Records
- Collections management
- Claim submission
- Patient billing
- Medicare and medicaid process
- Medical claims submission
- Electronic health record software
Timeline
Medical Billing Specialist (Remote)
Well Coast Medical Corporation
07.2024 - Current
Medical Biller and Coder
Orthopedic And Sports Medicine
03.2024 - 06.2024
Medical Biller
United Surgery Center
12.2023 - 06.2024
Medical Biller and Coder
Rancho Family Medical Group
11.2022 - 12.2023
Medical Biller and Coder Intern
24 Hour Urgent Care -
07.2022 - 10.2022
Associate of Science - Medical Billing And Coding
San Joaquin Valley College
Certification - Medical Billing And Coding
San Joaquin Valley College
Bachelor of Science - Health Care Administration
Arizona State University
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