Reyna Brower
Vail
Summary
Well-qualified professional, familiar with the medical revenue cycle and offering strong multi-tasking, detail oriented and teamwork abilities.
Overview
20
20
years of professional experience
Work History
Billing
HS Dermatology
Tucson
08.2022 - 01.2026
- Submit claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
- Answer customer invoice questions and resolved issues discovered during invoicing and collection process.
- Investigat and resolved issues to maintain billing accuracy.
- Contact insurance providers to verify insurance information and obtain billing authorization.
- Work with team members and leadership to identify and develop process improvements.
- Input payment history and other financial data to keep customer accounts up-to-date in system.
- Answer customer questions to maintain high satisfaction levels.
Medical Coder
Retina Associates
Tucson
03.2021 - 08.2022
- Read through patient health data, histories, physician diagnoses and treatments to gain understanding for coding purposes.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Assigned procedure and diagnosis codes for insurance billing using MDI.
- Verified proper coding, sequencing of diagnoses and accuracy of various procedures and surgeries.
- Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
Medical Biller
TMCONE Healthcare Medical Group
Tucson
11.2019 - 03.2021
- Applied HIPAA privacy and security regulations while handling patient information.
- Completed and submitted appeals for denied claims.
- Reviewed claims for coding accuracy.
- Coordinated communications between patients, billing personnel and insurance carriers.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Handled billing, waivers and claims for private and commercial clients.
Medical Biller
Tucson Shared Services Center
Tucson
04.2017 - 09.2019
- Handle all payers secondary billing for California hospitals
- Handle part B only Medicare billing for California hospitals
- Assist in secondary billing for Arizona, Nevada and New Mexico hospitals
- Ensure UB-04 clean claims are submitted in a timely manner
- Handle Rebill, Insbill and rejected pools
- Work KFI File accounts
- Mail clean UB-04 claims forms via paper
- Clear Share of Cost amounts from Medi-Cal website
Reimbursement Specialist
Tucson Shared Services Center
Tucson
11.2015 - 04.2017
- Process all payments and adjustments received in an accurate and timely manner
- Post all payments received through the lockbox or mailroom and adjustments as identified by insurance explanation of benefits
- Write up all payments on cash receipts log for payments that need to be uploaded
- Write up all adjustments that need to be uploaded on an adjustment log and submit for approval
- Balance posted payments before leaving each day
- Submit required paperwork (journal, batch out, batch cover sheets) daily
- Identify and resolve payment posting issues
- Call payers to obtain information on unidentified payments
Patient Service Specialist
University of Arizona Medical Center South Campus
Tucson
02.2011 - 03.2015
- Assist patients and medical staff in making appointments for radiology exams
- Answer phone calls and transfer to appropriate individual(s)
- Verify orders for proper exams according to protocol
- Assist technologist with correction of image errors
- Burn radiology images for requests of outside facilities
- Register ER patients into system
- Transport patients to and from the Emergency Room
Patient Access Representative
Carondelet Health Network
Tucson
02.2009 - 02.2011
- Register scheduled and walk-in patients
- Check insurance eligibility and any co-pay or deductible responsible by patient
- Prepare monetary bag for delivery to bank and prepare graph of daily totals
- Pull and scrub orders for next day patients for radiology exams
Cash ID Representative
Carondelet Health Network
Tucson
02.2008 - 02.2009
- Post all incoming money for radiology services to patients accounts
- Prepare monetary bag with correct total for checks and cash received daily for delivery to bank
- Call insurance companies to check status on claims
Front Office Receptionist
Advanced Open MRI
Tucson
04.2007 - 01.2008
- Verify insurance eligibility
- Verify prior authorization for CT Scans and MRIs
- Answer calls and obtain proper information for appointments
Medical Billing Specialist
Tucson Clinica Medica Familiar
Tucson
06.2006 - 03.2007
- Handle collections and denials
- Perform daily billing and posting for all insurances
- Prepare patient statements
- Submit paper and electronic clean claims
- Produce month end and Accounts Receivable reports using advanced Excel spreadsheet functions
Education
CPC -
LS Coding
Tucson, AZ08.2022
Certification - Medical Billing and Coding
Tucson College
Tucson, AZ06.2006
High School Diploma -
PPEP Tec - Celestino Fernandez Learning Center
Tucson, AZ04.2005
Skills
- Medical front office reception
- Verification of insurance eligibility
- Verification of prior authorization and claim status
- Appointment scheduling
- Medical office & hospital billing
- Collections
- ICD-10, CPT, HCPCS coding
- Health insurance contractual language (AHCCCS, Commercial, PPO, HMO, Medicare)
- Explanation of benefits and basic fee schedule review
- Preparation and submission of paper and electronic insurance CMS-1500 and UB 04 claim form
- Preparation of Accounts Receivable report
- Medical terminology
- Microsoft Word, Excel, PowerPoint, Outlook
- Medical office systems: Medisoft, Telecom, MDrythm, Meditech, Cerner, Epic, PACS Philips, Synapse, HMS, Artiva, Hyland, SSI, DDE, MDI, AdvancedMD, ModMed EMA
- Bilingual- fluent in Spanish
- Data entry of 40 wpm
- Ten key by touch
Timeline
Billing
HS Dermatology
08.2022 - 01.2026
Medical Coder
Retina Associates
03.2021 - 08.2022
Medical Biller
TMCONE Healthcare Medical Group
11.2019 - 03.2021
Medical Biller
Tucson Shared Services Center
04.2017 - 09.2019
Reimbursement Specialist
Tucson Shared Services Center
11.2015 - 04.2017
Patient Service Specialist
University of Arizona Medical Center South Campus
02.2011 - 03.2015
Patient Access Representative
Carondelet Health Network
02.2009 - 02.2011
Cash ID Representative
Carondelet Health Network
02.2008 - 02.2009
Front Office Receptionist
Advanced Open MRI
04.2007 - 01.2008
Medical Billing Specialist
Tucson Clinica Medica Familiar
06.2006 - 03.2007
High School Diploma -
PPEP Tec - Celestino Fernandez Learning Center
Certification - Medical Billing and Coding
Tucson College
CPC -
LS Coding