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Updated Resume Aug 6, 2015
- 1. Soledad M. Barron 1905 Blue bonnet Dr Round Rock, TX. 78664 737-333-5388 Cell SoledadMBarron@gmail.com Summary of qualifications: HIGHLIGHTS 揃 Exceptional planning, coordination and time management skills 揃 Top notch communications and interpersonal skills 揃 Excel at managing multiple projects and multi-tasking 揃 Ability to thrive in a fast-paced professional environment EXPERIENCE: August 2013 - Present Pain Specialists of Austin Austin,TX A/R Medical Billing Specialist Process medical claims for all insurances for pain mgmt and pain procedures for proffesional and ASC facility. Procedures consist of injections, DME and implants. Our billing dept bills for all 7 clinics and 2 ASC locations in TX. Submit corrected claims, reconsideration and appeals for proper processing and payment from insurance. My position has multiple rolls that consist of coding, billing and covering front desk at all locations when needed. I am also the assistant to the Billing Supervisor so I am in charge of training other billers, coders and front desk staff. Also responsible for resolving calls and questions for supervisor when supervisor is away from our corporate location. Our billing dept is in charge of contacting patients to discuss balance responsibility after ins has properly processed their medical claims. Setting up payment plans for patients and taking payments over the phone for any copay, coins or deductible payments using our Availity system. I also translate for Spanish speaking billing patients and assist the providers during procedure and follow up visits. Software/System: Centricity, Availity, Word, Excel, PowerPoint, Microsoft Outlook, Publisher and all insurance claim status insurancesite May 2013 August 2013 Superior Health Plan (Centene Corporation) Austin, TX Program Coordinator Initiate authorization requests for output or input services in keeping with the prior authorization list. Maintain integrity of PHI. Maintain working relationships with other departments. Research claims inquiry specific to the department and responsibility. Attend ongoing training andin-servicesas directed. Perform tasks necessary to promote member compliance suchas verifyingappointments, obtaining lab results. Assess and monitor inpatient census. Screen for eligibility and benefits. Identify members without a PCP and refer to
- 2. Member Services. Answers phone queues and faxes within established standards. Screen members by priority for CM assessment. Coordinates services with community based organizations, attends marketing andoutreach meetings as directed to represent the plan. Produces and mails routine CM letters andprogram educational material. Data enters assessments and authorizations into the system, maintainsdatabase as directed. Performs daily outreach OB assessments to coordinate Medicaidaccount to our members. August 2010 April 2013 Parkland Hospital Dallas-Cardiac Lab Dallas, TX Front Office Manager/Biller/Coder Check in/out all procedure, clinical andICD/PM patients, assespatients for initial learning andpsycho socials and refer to social worker on duty, order all office supplies and cath lab forms, create and enter orders for EP and Cath procedures, create monthly procedure charge report, weekly unsigned cath report for providers, monthly on call provider schedule for day andevening shift for entire hospital coverage, review all nurse/doctor charges after procedures performed and make sure all correct devices, implants and supplies are correctly charged before billing, answer 10 line phone system, managing front office staff, request and manage engineer orders for all staff, creating a report for all procedures performed for each year, utilizing excel with all excel formulas for all reports, work directly with ER/Cardiovascular/Pulmonary/Cardiology and OR Departments, Anesthesia scheduling andadmitting of patients, requesting all patient beds prior to procedure, requesting all medical records thru our EMR system within and outside of hospital, requesting Cath/EKG/Echo/TEE films from outside facilities, ordering all food for visitors/vendors or employees, overseeing cleaning staff and reportingto labmanager. Software: EPIC, EMR, Smartworks, Experand CIMS, Word, Excel, Microsoft Outlook, Publisher etc. June 2008 - 2010 ESI Network Dallas, TX Medical Biller/Collector Analyze and collect on Medicaid, Medicare, Workers Comp and Commercial claims that are 90 days past due. Duties consist of processing contractual adjustments, submitting appeals, contacting insurance companies in order to research and find why the claim was originally denied and submit any information needed in order to try to get this claim paid before the timely filing deadline, handle andsubmit medical records andall requireddocumentation on a dailybasis. Alsodeal with patients andthe facility on a daily basis. Run daily reports for all collectors' process andreport all money collected perclient. Software: STAR, Challenger andClaim Administrator thru the CitrixSystem. Familiarwith MEDAand Remit andRA reports July 12, 2004 - April 30th 2008 Fair Isaac Corp. Coppell, TX Worker's Comp. Medical Biller/Coder/Data-Entry/Customer Service Analyzing/Billing and researching Medical Bills for Fraud for Workers Comp. for all states, calling clients and patients for prompt payment of approved bills or bills requiring missing information. Mainly responsible for the state of Texas medical worker's comp bills. Also incharge of codingand researching all bills for specific accounts. I have worked andhelpedon several accounts since2004. I love learning new accounts and helping anyone who needs help, even if outside of my position description. Prepare and submit insurance billings to primary and secondary payers. Great knowledge of Physical Therapy, Pathology, Radiology, DME, Psychology, Orthopedic, HomeHealth, Pharmacy, Chiropractic, Inpatient andOutpatient Hospital billing andcoding. Workingwith HCFA1500, UB92, TWCC 69, TWCC 73, explanationof review, EOB's, NEW TWCC 73, Pharmacy forms and UB92. Software: Smart Advisor, Comp. Advisor, Paper vision, WindowsXP, Microsoft Outlook,Word, Excel,TMIC Claim Database,Client applicationimage viewer andPower Point
- 3. April 1, 2003- July 10, 2004 Corvel Corp Las Colinas, TX Medical Analyst/Coder/Data-Entry/Customer Service Analyzing/Billing andresearching Medical Bills for Fraudfor WorkersComp. Calling Clientsand patients for prompt payment of approvedBills or Bills requiring missing information.Worked withmany bills for anesthesiaandmedical Hospital bills for In-patient and Outpatient. Alsoin charge of coding all bills. Great knowledgeof HCFA1500 and UB92 forms. Software: Med-Check, Kia,Windows XP, Microsoft Outlook, Word, Excel, Power Point 2001- 2003 Quest Diagnostics Clinical Lab Irving, TX Medical Billing/Data Entry/Customer Service Billing patient's medical insurance and billing doctors and hospitals accounts. Inbound and outbound calls to patients and clients, creating spreadsheets for weekly reports for my department, handling New Orleans, Dallas and Houston accounts. Printing daily reports: Referring Physician, Eligibility, Write-offs, Wrong 3 pf Codes. Investigating accounts to find out which insurance is primary. Entering missing information: ICD 9 codes, patient's address, Date of birth, insurance address, referring physician, researching EOB's etc. Worked with all insurances including Medicare Part A and B and Medicaid. Also responsible for handling a fourteen-line switchboard on assigned week for Receptionist lunch and breaks. Also helped BDE Department in keying in Requisitions into the Top LabSystem on a weekly basis. This jobalso includeda lot of researchof accounts andlearning all applications used for all departments. Knowledgeof almost all Medical Insurances andrequirements. Software: Microsoft Word, Excel, QBS, NBS,Top Lab, FIS Viewer, Insurance Database, Microsoft Outlook and Windows NT 2000-2001 Walnut Hill Lutheran Church Dallas, TX Office Manager/Secretary - Part time position Performing Daily Task: Spreadsheets, Word Documents, Scheduling Weekly Assignments, and Setting-up the conference Room for weekly meetings, worked on two weekly Sermons three to ten pages long in English and translated into Spanish. Responsible for scanning, answering and directing a five line phone to the appropriate party. Taking appropriate and accurate messages for the congregation. Performed many task as assigned by all congregation and directors of the church. Responsible for receiving and distributing mail on a daily basis. Sending out weekly postcards and letters to individuals scheduled to be in Sunday's Sermon and letters to other congregations. Worked on a Church Newspaper on a daily basis to be ready by the end of the month. This newspaper included paragraphs and pictures from the congregationand was to be set up on a monthly basis. I alsokept andmaintained all office supplies andwas incharge of maintaininganddistributingall office supplies including fax machinesand copymachines. Software: Macintosh/Windows 95, Quark Express, Microsoft Word, Excel, PowerPoint, and Publisher 1998-2000 Smith-Kline Beecham Clinical Lab Dallas,TX Medical Billing/Data Entry/Customer Service Billing patient's medical insurance, entering new billing information onto a Top Lab system. Worked with almost all medical insurance, including Medicare and Medicaid. In charge of making copies of requisitions that are in question or are not viewable. Making and receiving calls for proper billing information from patients and doctors. Also madecollection calls to patients to let them knowthey are responsiblefor the amount owed for medical services performed.
- 4. Software: Excel, Microsoft Word, Peach Tree,Power Point, NBS, Top Lab and AS400 1996-1998 H&K Dallas Dallas, TX Purchasing Secretary Cutting Purchase orders, keying invoices, locating equipment purchased. Doing inventory that included a weekly and monthly excel spreadsheet containing how much equipment was sold, what we had on hold and what we had available. Relieved the switchboard operator three times a week, faxing, copying, and a lot of data-entry, also made copies of extremely large equipment drafts on a daily basis, and I filed all drafts and product information. In addition, I also did several assignments for the purchasing department on an everyday basis. Software: Excel, Microsoft Word, Access, Lotus, AS400, Windows 95 Education: 2012-2013-Relocated Art Institute Dallas, TX Computer Animationand Graphic Design 2006-2008 DevryUniversity Irving, TX Engineer in Electronics August 1995: ReceivedDiplomafrom Sunset High School Additional professional activities: I havetaken someextra courses at DevryUniversity in Writing/SpeechandSoftwareto improve or addto my proficiencyin Writingand Softwareapplications. I am alsoproficient in Windows95, 97, 98, 2000, Windows Me, WindowsXP, Windows Vista, WordPerfect, & Macintosh. Languages: Proficient inEnglish andSpanishthat includes reading, writing andspeech. Objective: My objective is to find a good company who has the passion for what they do, a company who sets goals and strives to meet those goals. I myself work very well under pressure and would like to be part of a team who is there to work and has the best interest in the company's reputation. I am alsoa person whois there to be part of a team andto do what needs to bedone to help the company out evenif it isnot in my jobdescription. Interests/Goals andactivities: My education hasno goal sincemy educationwill be a continuing one. I also loveto volunteer at my local churchand at DFW Humane noanimal kill shelter. I am interested intaking anyclasses that will help me advance inmy positionat work.