Lorena M. Email & Phone Number

Sacramento County, California, United States

• Communicate with staff and providers to ensure referral process is done in a timely manner • Redirect referrals to other specialist to resolve authorization denials • Review provider notes for correct CPT and ICD-10 codes • Contact internal and external offices to obtain medical records • Process referrals with Medicaid, Medicare, and commercial insurance via IPA portal • Follow up calls with the specialists to ensure they have the necessary documents to accept the referral • Notify patients authorizations have been approved • Answer and resolve any issues the patient may have • Daily tracking of patient accounts to process referrals in a timely manner and update patient accounts

Sacramento, California, United States

• Daily reviewed billing and adjustments for accuracy and timeliness • Interpreted explanation of benefits (EOBs) for resolution • Performed follow up on outstanding aging account balances for patient and insurance • Supported front office staff with insurance and account questions • Sent statements with outstanding balances to patients• Posted EOB batch payments and made necessary adjustments • Submitted appeals to insurance companies • Processed denials to resolve patient's outstanding balance • Communicated with patients to resolve outstanding balances

Sacramento, California Area

• Coded multi-specialty outpatient visits with a case load of 2,000 per months • Assigned appropriate ICD-10 diagnostic codes • Assigned current procedure (CPT) for minor procedures • Experience in assigning Evaluation and Management levels • Assigned HCPCS and modifiers per payer guidelines • Reviewed chart notes for provider compliance • Demonstrated knowledge and ability to assign diagnostic codes to the highest specificity • Abstracted relevant information from patient records to support accurate level of service • Audit documentation for missing information and query providers to update notes • Reviewed and edit generated eClinicalWorks software codes • General understanding of CMS documentation and coding and billing guidelines • Researched applicable rules, policies, and guidelines to resolve coding denials

Sacramento, Ca

• Resolved insurance denials by; submitting additional documentation; making the necessary corrections and re-submitting claims; or submitting appeals with supporting documentation • Conducted routine research and follow-up on unpaid claims • Communicated with insurance companies to resolve patient’s billing • Obtained authorizations with insurances • Verified patient’s eligibility and benefits • Accurately documented in Epic system actions taken on each account

Associate Of Arts - Aa, Medical Billnig And Coding, A

Certificate, Office Administration