1. Felicia Ortega
1959 E 39th Ave
Apache Junction, AZ 85119
480-458-8691
feliciaoretega@gmail.com
BACKGROUND
 Experiencedmedical professional withadiverse backgroundinaccountsreceivable inmedical
collections,billingaswell ascustomerservice.
 Effective communicationskills-withthe abilitytoworkwith othersas well ason an individual
basis.
 9 yearsof billingandcollectingwithCommercial,AHCCCS,Medicare SupplementInsurances,
Correctionsbillingaswell ascontractnegotiations,EOB,COB,andElectronicbillingandremits.
 Proficiency in Windows 2007-10, MS Word, Excel, Calendar Scheduling, HMS, SSI, Stockell, 10
Key, HCFA, UB’s, PARA, NPPES, DSG, CPT, ICD-9, ICD-10 AND DDE.
PROFESSIONAL EXPERIENCE
Florence Hospital at Anthem Account Resolution Specialist-Lead 3/8/2012-Present
 Work closely with 13 different Correction facilities to ensure inmate ID and
Authorizations were accurate to ensure clean claims with payment turnaround times
less than 45 days.
 Responsible foridentifyingpotential problemsaswell ascreatinganeffective alterative
in the collection portion of accounts receivable.
 ReviewedAdjustmentRate changes,Denials,Remitdiscounts,Write offs,Timelyfilingto
assure these are correct and performed in a timely manner.
 Appealed denied or underpaid claims and was successful in obtaining 95-100% total
billed charges from Non-Participating Providers.
 Negotiationswithpayersforlow allowable amounts and reprocessing of claims that do
not meet ACA guidelines.
 Successful inoverturninglow payment allowances from BCBS and accelerate cash from
BCBS collections for out of network providers.
 Aggressive negotiations with Multiplan and Viant resulting in 96% of billed charges.
 Our team was able to successfully reduce AR by 7 million in 6 months.
 Successful go live implementation of DSG claims management system.
GilbertHospital BCBS Account Representative,CorrectionsSpecialist(Collections) 11/11/08-2/3/14
 Strong leadership and communications skills: planned and coordinated training
programs for registration staff for both hospitals.

2.  Responsible for identifying potential problems as well as creating an effective
alternative in the collection portion of accounts receivable.
 Reviewed and Adjustment Rate changes, Denials, Remit Discounts, Write offs, Timely
Filing to assure these are correct and performed in a timely manner.
 ReviewandassistedwithNewandRevisedcontractsalongwithanyproblemsthatare
affiliatedwhenthe termsof the contractsare notmet.
 WorkedBCBS and CorrectionsaccountsforbothGilbertHospital andFlorence Hospital
at Anthem.
Sonora Quest Laboratory Phlebotomist 10/1/1999-11/1/2008
 Responsible forcollectingspecimensform patientsinanoffice setting.
 Ensuringall correct paperworkfromorderingPhysician’saswell asall correct
insurance informationforbilling.
 Completedall specimenprocessingtoensure the collectedspecimensqualityforprocessing.
 Able tocommunicate efficientlywithall Physiciansandmedical staff aswell aswiththe patients
inorder to reduce waittime andunnecessaryredraws.
EDUCATION
CurrentlyattendingCentralArizonaCollege:Associatesof AppliedSciences:RHITprogram:
Completiondate:August2016
PimaMedical Institute (Certificate Medical Assistant1998)
Mesa HighSchool (Diploma 1995)
References
GidgetHudson – Businessoffice Manager- (480) 287-6079
PatrickClune – Chief Financial Officer- (281) 660-7180
ElenaFernandez –CollectionsSupervisor- (480) 540-0758