Thitthida Rhoades Email & Phone Number

Greater San Diego Area

San Diego, California

• Responsible for all EDI transactions 837P, 837I, 276, 277, 270, 271, 835.• Participates in the testing process of new software or system upgrades• Responsible for reporting on EDI transaction volumes, and EDI reconciliation processes• Creating SOP’s and workflows.• Responsible for updating and adding Providers into database based on credentialing• Trading partner enrollments and validating EDI files.• EDI volume maintenance – monitors and verifies submission and reports them weekly and or/monthly to leadership.• Research and edit encounter data errors and rejection reports• Eligibility research and verification• Responsible for generating EDI transactions.• Work with the external EDI vendors to resolve claims data issues, testing EDI transactions and analyzed errors for correction, when appropriate.

San Diego, California

Performed authorization request from providers.• Utilize various software systems to determine eligibility.• Provide excellent customer service to patients and providers.• Performed authorization request from providers.• Utilize different software to research and determine eligibility.• Answer phone calls for offices, hospitals, and patients using exemplary customer service skills• Accurately enter required information into computer database• Review structured clinical data matching it against specified medical terms and diagnoses or procedure codes, and follow established procedures for authorizing request or referring request for further review

Loma Linda, California

Meticulously tracked and resolved underpayments and overpayments.• Remained up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.• Performed quality control of the data entry system to verify that claims encounters and payments were posted correctly.• Billed all lab claims with attached lab slips.• Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.• Thoroughly investigated past due invoices and minimized number of unpaid accounts.• Recorded and filed patient data and medical records.• Performed various claims adjudication duties.

San Dimas, California

Remain up-to-date with all insurance requirements, including the details of patient financial responsibilities, fee-for-service and managed care plans.• Performed quality control of the data entry system to verify, that claims and payments were posted correctly.• Prepared and attached all required claims documentation including referrals, treatment plans or other required correspondence to reduce incidence of denials.• Billed multiple Physician clinics, thoroughly investigated past due invoices and minimized number of unpaid accounts.• Recorded and filed patient data and medical records.