Zaina Melendez
Santa Ana,CA
Summary
Having 7 years of extensive experience in medical billing and coding I have been able to grow my capacity in this field. I am excited to implement the knowledge and skills I have gathered throughout my professional experience and apply it to my next career opportunity.
Overview
7
7
years of professional experience
Work History
Medical Billing Manager
EHR CONSULTANTS & BILLING INC
06.2017 - Current
- Checked each insurance payment for accuracy and compliance with contract discount
- Comprehensive knowledge of ICD-9 and ICD-10 Diagnostic and Procedural Coding, Current Procedural Terminology Coding, HCPCS Level II Coding and Coding Compliance
- Experienced with a variety of Medical Practice Management Software, as well as Electronic Health Records
- Familiar with CMS-1500, EOB, SOAP Notes and office procedures
- Identified any overpayments and/or duplicate payments, and investigated and resolved issues
- Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid
- Proficient in Microsoft Office Suite, Medisoft
- Proficient in other general medical administrative duties as required
- Researched and appealed denied claims
- Responsible for insurance aging, patient account aging follow-up and resolution
- Understanding of Medical Insurance, Billing, Collections and Reimbursement
- Updated billing software with rate changes
- Updated cash spreadsheet, runs, and collection reports, Called insurance companies regarding any discrepancy in payments if necessary
- Checked eligibility and benefit verification
- Comprehension of CPT, ICD-10-CM, HCPCS/Modifiers and Auditing
- Interpreted patients medical charts and assigned appropriate CPT,ICD-10,and modifiers
- Reviewed claim rejections & clearinghouse reports
- Knowledge of Anatomy, Physiology and Medical Terminology
Front Store Supervisor
Chick-fil-A
- Greeted visitors and customers upon arrival, offered assistance, and answered questions to build rapport and retention.
- Responded to customer concerns with friendly and knowledgeable service and remedied issues promptly and effectively.
- Offered hands-on assistance to customers, assessing needs, and maintaining current knowledge of consumer preferences.
- Trained team members in successful strategies to meet operational and sales targets.
Lead Medical Biller
Mountain View Medical Laboratory
12.2023 - Current
- Improved billing accuracy by diligently reviewing and updating patient information in the system.
- Reduced errors in medical coding by cross-checking codes against diagnoses and procedures.
- Streamlined claim submission processes for faster reimbursements, collaborating with insurance companies on a regular basis.
- Enhanced revenue collection with consistent follow-ups on outstanding accounts and negotiating payment plans when necessary.
- Led a team of billers, providing guidance and training to ensure timely completion of tasks.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility.
Education
MEDICAL BILLING AND CODING
UEI COLLEGE
Anaheim, CA06.2017
Skills
- Insurance Claims Analysis
- Extensive knowledge of insurance, PPO, HMO &
Medi-Cal
- Billing and Collection Procedures
- Claims Processing
- Chart Auditing
- Multitasking and Organization
- Claims review
Languages
Spanish
Full Professional
English
Full Professional
Timeline
Lead Medical Biller
Mountain View Medical Laboratory
12.2023 - Current
Medical Billing Manager
EHR CONSULTANTS & BILLING INC
06.2017 - Current
Front Store Supervisor
Chick-fil-A
MEDICAL BILLING AND CODING
UEI COLLEGE
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