Sofia Escobales
Columbus City,IA
Summary
Experience of 12 years’ plus in the banking field, 1- year plus as a patient account representative, 5 year’s plus as a follow up associate, highly motivated, positive attitude, quick learner, seeking a suitable remote position as a follow up associate.
Overview
20
20
years of professional experience
Work History
Follow-Up Associate I
R1 RCM
01.2021 - Current
- Review Commercial Behavioral Health, Medicaid Behavioral Health, Medicaid Secondary and Medicaid Registration denials claims, for POS-place of service 21-Inpatient Hospital, 11-Office, 19-Off Campus Outpatient Hospital, 23-Emergency Room Hospital, for the states of Washington, Montana and Idaho.
- For claim resolution, send to coding for review depending on denial to check if CPT codes and Diagnosis are correct, submit corrected claims, reconsiderations, and appeals (with medical records when needed) via payer portals or fax, call payers when needed for further detailed information on rejection/denial remarks, verify fee schedules for max allowable rates, research payers billing guides, send out smart text letters when COB-coordination of benefits needs to be updated by the patient.
- Submit adjustment/write-off (non-covered, timely filing, max allowable, financial assistance Medicaid no prior authorization, bundled service, cost to collect).
- Verify patient eligibility, claim and appeal status through the following portals, One Health Port includes, Ambetter, Coordinated Care, Kaiser Permanente, Premera BC, Community Health Plan, Moda Health, Provider-One, Availity, Montana Medicaid, Idaho Medicaid, Noridian Medicare, United Healthcare.
- Update VFO-Visit Filing Order for registration denials.
- Payers I work, Aetna, Allegiance, BCBS, Medicare, Champva, Tricare, Medicaid, MCO’s (Coordinated Care, Community Health Plan, Molina, WellPoint), Humana, Kaiser, Moda, Premera, Regence, United Healthcare.
- I have experience with Word, Microsoft Email, Excel, FinThrive/nThrive, Epic, Workday, MUE=Medically Unlikely Edits Lookup Tool, NPPES NPI Registry (National Plan and Provider Enumeration System), Taxonomy Code Look up Service, NDC (national drug code list), Genesys Cloud (for outbound and inbound calls), Microsoft Teams, One Note, snipping tool, Google chrome, and notepad.
- Work well with supervisors, QA, leads, IT, and co-workers.
- Discipline to stay on top of task and balance quality and productivity.
Patient Account Representative
Washington County Hospital and Clinics
Washington, IA
02.2019 - Current
- Review emergency room and observation Medicaid claims, ensure the claims have no errors and are ready for submission.
- Review denied claims, submit corrected claims and appeals to IME and MCO’s.
- Check patient eligibility with Iowa Medicaid, Amerigroup and Iowa Total Care.
- Assist patients with billing questions in regards to co-pays, coinsurance, deductible, services rendered, balance on accounts.
- Prepare the bank deposit, which includes commercial payments and private pays.
- Familiar with HIPPA Compliance.
Assistant Manager/Loan Officer/Collector
Lpi Loans, INC
Cedar Rapids, IA
03.2018 - 10.2018
- Assisted new applicants/existing customers to gather information, answer questions and help guide through the application process.
- Explained the term and rate that applied to the applicant depending on the amount of the loan requested.
- Appraised vehicle’s value on NADA when utilizing for collateral, communicated with auto insurance agents to obtain a copy of Binder providing full coverage insurance information and confirming LPI as the lien holder.
- Collected, verified, and analyzed the applicants financial/personal information, such as the credit report, net to year income, photo Id and SSN.
- Approved loans, referred applications outside approval limit to manager, and declined loans followed with counsel on how to improve their credit history.
- Offered insurance available, such as Credit Life, Accident & Health, Involuntary Unemployment, Property & Casualty, and informed them on terms and fees for each insurance.
- Set up appointments with applicants, booked loans, and closed loans.
- Scanned legal documents to system and imported them to the account, ensured all documents got organized in the right stack order.
- Forms familiar with, auto appraisal, Iowa Dot lien form, insurance agreement, cures, final notice.
- Contacted customers who failed to make their loan payments, worked with customers to help them stay on track with loan.
- Initiated collecting steps if customer continued to miss payments, such as, Cures, Final Notice, and referred account to manager for repossession of vehicle.
- Assisted receptionists when needed with duties, such as taking payments, and answering the phone.
Bookkeeping/Head Teller/Teller
Community Bank & Trust
Muscatine, IA
01.2006 - 03.2018
- Reconciled money order, cashier’s check, and expense accounts.
- GL/ATM balance, balanced all branches ATM’s to the general ledger.
- Cash Balance, balanced all branches teller drawer to the general ledger.
- Obtained obit information to provide to loan officers: such as full name, date of birth, accounts opened, and interest earned or owed.
- Mobile deposits, proof read checks and uploaded to deposit to customer account.
- Debit/ATM cards, reset pins and ordered cards.
- Internet banking, reset passwords, unlocked accounts, and added accounts for customer to view.
- Statements, analyzed, corrected, printed and stuffed in envelope and delivered to post office to mail out to customer.
- CD’s, printed certificates of deposit and mailed out to customers informing them on maturity date.
- NSF’s (Not Sufficient Funds), returned checks and mailed out notice to customer.
- IRD (Image Replacement Document), printed image and mailed out to customer.
- Wire transfers, would perform dual control finalization.
- IAT (International ACH Transaction), would print and mail out notification of transaction to customer.
- Stop pay, canceled checks per customer requested.
- Assisted customers/tellers with bookkeeping questions.
- Head teller duties, assisted customers, order Fed Cash, supervised tellers, balance vault and drawer on a daily basis.
- Teller duties, assisted customers, wrap coin, opened new accounts, interpret for loan officers, balanced drawer and trained new tellers.
Education
High School Equivalency -
Excel Part 1 -
Skills
Bilingual
Strong interpersonal skills
Understanding of confidentiality
Integrity
Data entry skills
Analytical skills
Decision-making skills
Attention to detail
Problem solving
Multitasking
Disciplined
Timeline
Follow-Up Associate I
R1 RCM
01.2021 - Current
Patient Account Representative
Washington County Hospital and Clinics
02.2019 - Current
Assistant Manager/Loan Officer/Collector
Lpi Loans, INC
03.2018 - 10.2018
Bookkeeping/Head Teller/Teller
Community Bank & Trust
01.2006 - 03.2018