Julie Urias has over 25 years of experience in accounting, relationship management, and medical billing. She currently oversees billing functions and the daily operations as the University Billing Supervisor. Previously, she held various roles with increasing responsibility in medical billing and claims processing, including resolving complex billing issues and developing solutions to improve workflows. She has a track record of strong performance, exceeding accuracy and timeliness goals.

1. Julie Urias
5057 Cherryview Drive
(801) 440-0690 jurias6699@aol.com
Objective:
To acquire a rewarding career position, utilizing skills and experience I have developed in the
accounting/relationshipmanagementindustry.
Professional Experience:
UNIVERSITY BILLING SUPERVISOR – October 1, 2015 – Present
• Oversees billing functions. Also includes implementing new goals and procedures,
Overseeing daily operations and coordinating office efforts to expedite payment of accounts
• Supervises staff members by directing workflow, training and evaluating performance.
• Writes, generates and evaluates a variety of reports for financial and managerial audits.
• Initiates audits based on process evaluations.
• Develops and coordinates the billing processes between staff members, departments and outside agencies.
• Monitors the charge-adjustment-receipt structure and initiates changes or improvements
• Responsible for overseeing the billing and collections of assigned area by ensuring revenue maximization while
maintaining a cost-effective operation.
UNIVERSITY MEDICAL BILLING SPECIALIST – October 2012 – September 2015
• Resolves various billing edits within established timelines
• Identifies trends and issues, verbally communicates the issues and propose solutions to the supervisor
• Follow-up (phone and e-mail) with departments regarding claim submission through our practice management
system
• Resolves various billing edits and denials within established timelines
• Follow-up (phone, e-mail and regular mail) with insurance companies/patients regarding claim/payment status
through our practice management system
• Composes/writes appeal letters using the established insurance guidelines to resolve collection barriers
• Responds to written and email correspondence within established timelines
• Prepares a written summary of departmental issues and concerns for supervisor
• Answers phone calls and assists customers in-person to resolve issues by established timelines
• Medicare Training, Special Projects, Uses a logical approach to identify the root cause Research
• Compliance Appeals and Follow-up
Principal Financial Group – Health Division 1995-2012
SR. CLAIMS ACCOUNT SPECIALIST – February 2009 - February 2012
• Research, analyze, and resolve complex claim issues to various contract and plan provisions with
minimal supervision/direction
• Identify solutions to claim questions and issues.
• Specialized in Medicare and Medicaid.
• Educate and provided technical support including mentoring and acting as a resource for coworkers

2. • Assist Leadership staff with workflow management, quality review, training and other staff responsibilities
• Communicate with external customers, other departments such as Legal, Special Investigation Unit,
Network Operations and third parties to resolve claim issues and or complaints.
• Assist in client presentations and audits internal and external
• Lead and participate in projects where recommendations are made pertaining to claim issues, system
enhancements, processes/procedures
• Prepare reports for management leadership
• Work directly with Carewise audit company in verification of claims over 10K
• Work directly with HRGI negotiation company of claims over 50K for possible negotiations and then payment
of these claims
• Specialize in Dialysis and Transplant claims processing and procedures
• Assist in request for authorizations for issues outside the policy
• Responsible for 500-3000 lives self-funded accounts
CLAIMS SPECIALIST – June 2001 - February 2009
• Communicated with customers regarding claim decisions, status and all aspects of the claim process.
• Analyze, Research and resolve complex PPO issues
• Handle claim reconsiderations, overpayments and making corrections
• Assisted as a claim technical resource
• Assist Brokers and Agents with questions and issuers that come from potential new clients and business.
• Receive incoming calls from vendors, customers, brokers, groups and providers.
• Analyze the callers’ needs, research information, answer questions and resolve issues
• Sent written correspondence to customers to provide information about the plan benefits.
• Made claim decisions in the on-line computer system bases on various contracts, plan provisions, and State and
Federal regulations.
• Analyze and investigate Medical, Dental, and Vision and financial information to make effective and timely decisions.
• Understand and take appropriate administrative decisions in accordance with guidelines included clinical evaluations.
• Evaluate claims per plan provisions, determination of eligibility, verification of data input, identification of
correct benefit level, calculation of fee schedules, coordination of benefits, and making corrections,
• Monitor and follow up on all outstanding items to ensure compliance with service timings, quality, and production
SR. CLAIM REPRESENTIVE - June 2001 - December 2001
• Communicated with customers regarding claim decisions, status and all aspects of the claim process.
• Mentor and Supervise fellow co-workers on the team as subject matter expert and contact for specific accounts
• Receive incoming calls from vendors, customers, brokers, groups and providers.
• Analyze the callers’ needs, research information, answer questions and resolve issues
• Sent written correspondence to customers to provide information about the plan benefits.
• Made claim decisions in the on-line computer system bases on various contracts, plan provisions, and State and
Federal regulations.
• Analyze and investigate Medical, Dental, and Vision and financial information to make effective and timely
decisions.
• Understand and took appropriate administrative decisions in accordance with guidelines included clinical
evaluations.
• Evaluate claims per plan provisions, determination of eligibility, verification of data input, identification of correct
benefit level, calculation of fee schedules, coordination of benefits, and making corrections,
• Monitor and follow up on all outstanding items to ensure compliance with service timings, quality, and production
• Mentor fellow co-workers on the team and service as a subject matter expert or contact for specific accounts
CLAIMS REPRESENTIVE – February 1997 - June 2001

3. • Review, analyze and process complicated and/or questionable claims.
• Demonstrated good communication skills in advising claimants, policyholders and others on claim actions
• Meet or exceeded performance of a combined dollar and Procedural accuracy of 99.3%
• Provide input on solutions on department problems
• Successfully met the appropriate educational course work
• Responded promptly and accurately to unusual claim situations or benefits
CLAIMS EXAMINER – June 1995 – February 1997
• Reviewed, evaluated and processed Medical, Dental and Vision claims for self-funded and fully insured clients
within ERSIA timing guidelines. Continually exceeded all performance expectations.
• Handled inbound and outbound calls from internal and/or external clients with the highest level of quality.
• Meet or Exceeded accuracy goals of 98.7% dollar accuracy having twice the weight of procedural.
• Communicate denials and requests for additional information to the proper parties
• Responsible for processing all claims
• Exercise a degree of Judgment on questionable claims
• Provided input on solutions to department problems
Accomplishments:
• Performance Management 5 Point scale, achieved a total competency score of 3.8 for 2011 performance
review. The average score within the Health division was 2.7
• Achieved Customer/Broker satisfaction survey results average 97% which exceeded 87% goal
• Individual combined quality results average 99.6%. Quality expectation goal was 99.1%
• 93.6% of all claims were paid within 10 business days through October 2011. Year to date results of overall
claim work in process through November was 2.6 days. Goals are to keep overall claim work in process less
than 6 business days.
• Consistently achieved independent external health plan audit results of 95% or better.
Community Service
• BACA (Bikers against Child Abuse, a non-profit organization).
1. Served on the chapter general board as the child liaison for ten years.
2. Organized the Christmas and Summer Parties for the children
3. Assigned members to assit as primary contacts to individual children
4. Responsible to communicate the needs of the family to individual children
5. Followed up with families to assure the needs of the child were being met by the Chapter
Education
• Phillips Junior College - Salt Lake City Utah
Industry Education
• Current on all Health Insurance Association of America (HIAA)
References upon Request