Annette Cruz
Manteca,CA
Summary
Professional, Self-Starter. I am a highly motivated team player seeking a position within an organization that offers career growth and advancement opportunities. Knowledgeable Patient Registration Representative highly proficient in coordinating smooth admissions and appointment registrations. Well-versed in current codes and insurance procedures. Detail-oriented in building and updating files.
Overview
16
16
years of professional experience
Work History
Health Records Technician
California Health Care Facility
Stockton, CA
09.2023 - Current
- Created detailed logs to track the location of stored materials.
- Managed the destruction of confidential records according to company policy.
- Retrieved files from automated databases for review or updating.
- Updated file folders with current contact information when required.
- Ensured compliance with all applicable policies regarding the handling of confidential materials.
- Maintained records management systems and updated filing procedures.
- Identified discrepancies in record keeping and corrected errors where needed.
- Located requested items using various search methods such as keyword searches or cross-referencing data fields within a database system.
- Reviewed, sorted and indexed documents according to established guidelines.
- Researched historical archives for specific information upon request.
- Scanned paper documents into electronic format for storage in computer databases.
- Audited existing records to ensure accuracy and completeness prior to archiving.
- Processed requests for access to confidential information according to applicable laws and regulations.
- Operated a variety of office equipment including scanners, copiers and printers.
- Researched, gathered and provided records information in response to requests submitted by phone and fax.
- Scanned, saved and organized hard copy and digital documents in computerized file library.
Customer Service Representative
PriMed Consulting/ Hill Physicians
San Ramon, CA
11.2021 - 08.2023
- Answered incoming telephone calls to provide store, products and services information.
- Provided outstanding service to new and long-standing customers by attending closely to concerns and developing solutions.
- Asked probing questions to determine service needs and accurately input information into electronic systems.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Explained benefits, features and recommendations to maximize client retention.
- Made outbound calls to obtain account information.
- Escalated customer concerns, issues and requirements to supervisors for immediate rectification.
- Reviewed account and service histories to identify trends and resolve issues.
- Answered inbound calls, chats and emails to facilitate customer service.
Claims Analyst
Primed/Hill Physicians
Stockton
11.2021 - 08.2023
- Managed escalated cases involving high-value claims or multiple parties involved.
- Analyzed claim data to identify trends and recommend process improvements.
- Conducted investigations to gather evidence in support of claims resolution.
- Evaluated requests for additional benefits or changes in existing coverage levels.
- Provided guidance to customers regarding their rights and obligations under policy terms.
- Reviewed appeals filed by claimants who were dissatisfied with initial decisions made concerning their cases.
- Reviewed customer claims, identified discrepancies and determined appropriate course of action.
- Maintained accurate records of all claim activities in accordance with company policies.
- Assessed medical records for coverage eligibility and benefit accuracy.
- Verified documents to ensure accuracy of information provided by customers.
- Advised customers on filing requirements, documentation needed, and other matters pertaining to their claims.
- Maintained confidentiality of claimant information in accordance with privacy laws and regulations.
- Followed all company procedures to keep data confidential.
- Analyzed claims data to determine coverage and liability, ensuring accurate decision-making.
- Reviewed and processed insurance claims following company procedures and industry regulations.
- Gathered proper documentation and data to prepare claims for submission.
- Utilized claims processing software to update and maintain accurate claim files.
Patient Registration Clerk
San Joaquin General Hospital
French Camp, CA
04.2021 - 10.2021
- Updated patient demographic information in Cerner to prevent treatment and recordkeeping errors.
- Screened patients before and during admissions processes.
- Used sliding payment scale to assess fair charges for patient healthcare.
- Prepared patients for departure by coordinating discharge plans and paperwork.
- Verified insurance and collected critical data elements to properly identify and bill patients.
- Met needs of physicians and other treating team members with timely retrievals of patient medical records.
- Protected medical information against unauthorized access, loss or corruption by consistently following security protocols.
- Registered patients using proper data entry.
- Collected all insurance information along with patient's photo I.D and social security number to ensure the most accurate information.
Call Center Representative
Zeiter Eye Medical Group, Inc.
Stockton, CA
10.2012 - 04.2021
- Call Center Lead
- Process over 100 calls in a typical day.
- Assist patients with appointment scheduling.
- Patient referrals and insurance verifications
- Maintain strict confidentiality in accordance to HIPPA guidelines.
- Met or exceeded call speed, accuracy and volume on consistent basis.
- Maximized office efficiency by answering more than 100 incoming calls per day to provide office information and transfer calls to desired personal.
- Interviewed patients to collect medical information and insurance details.
- Informed patients of financial responsibilities prior to rendering services.
- Entered patient information including insurance, demographic and health history into the system to keep all records up-to-date
- Answered multi-line phone system and directed callers to requested personnel and departments.
Medical Receptionist/Patient Registration Representative
Zeiter Eye Medical Group, Inc.
Stockton, CA
10.2012 - 04.2021
- Verified insurance and collected critical data elements to properly identify and bill patients.
- Processed patient payments and scanned identification and insurance cards.
- Took messages from patients and relayed them to the appropriate staff.
- Pleasantly greeted each patient and offered the desk sheet for easy sign-in.
- Entered patient information including insurance, demographic, social security number and health history into the system to ensure that all records were up-to-date
- Communicated with all partners throughout the practice including physicians, nursing staff, technicians and medical assistants.
- Set and managed patient appointment schedules using EHR.
- Ensured HIPAA compliance.
- Interviewed patients to collect medical information and insurance details.
- Compiled physical and digital paperwork to meet business and patient needs, including charts, reports and correspondence.
- Informed patients of financial responsibilities prior to rendering services.
- Entered patient information including insurance, demographic and health history into the system to keep all records up-to-date
- Set up appointments for physician visits and procedures using calendar software.
- Took messages from patients and promptly relayed to appropriate staff.
- Straightened up the waiting room so that it remained neat and organized.
- Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
- Screened patients before and during admissions processes.
Receptionist
Center For Sight
Stockton, CA
10.2008 - 10.2010
- Straightened up the waiting room so that it remained neat and organized.
- Set up appointments for physician visits and procedures using calendar software.
- Observed strict HIPAA guidelines at all times according to company policy.
- Processed patient payments and scanned identification and insurance cards.
- Ensured that the phone was answered by the second ring and enthusiastically greeted all callers.
- Took messages from patients and relayed them to the appropriate staff.
- Pleasantly greeted each patient and offered the desk sheet for easy sign-in.
- Entered patient information including insurance, demographic and health history into the system to ensure that all records were up-to-date
Education
Certificate - Medical Office Specialis
Maric College - Stockton
stockton, CA2008
High School Diploma - High School
Josefina Leon Zayas
Jayuya2002
Skills
- Computer proficient
- Bilingual in Spanish
- Quick learner
- Call center experience
- Professionalism
- Relationship Building
- Training experience
- Interpersonal skills
- Performance monitoring
- Phone answering
- Medical History Recording
- Clerical Functions
- Appointment Scheduling
- Attention to Detail
- Office Health Records Preparation
- Patient Medical Records Maintenance
- EMR Systems
Timeline
Health Records Technician
California Health Care Facility
09.2023 - Current
Customer Service Representative
PriMed Consulting/ Hill Physicians
11.2021 - 08.2023
Claims Analyst
Primed/Hill Physicians
11.2021 - 08.2023
Patient Registration Clerk
San Joaquin General Hospital
04.2021 - 10.2021
Call Center Representative
Zeiter Eye Medical Group, Inc.
10.2012 - 04.2021
Medical Receptionist/Patient Registration Representative
Zeiter Eye Medical Group, Inc.
10.2012 - 04.2021
Receptionist
Center For Sight
10.2008 - 10.2010
Certificate - Medical Office Specialis
Maric College - Stockton
High School Diploma - High School
Josefina Leon Zayas