Karla Rodriguez
Hialeah,FL
Summary
Logical Medical Biller proudly offers many years of experience reviewing accounts and maintaining patient records. Driven professional with background in medical terminology and coding. Recognized task prioritization expertise in fast-paced environments. Skilled in reconciling accounts, identifying discrepancies, and resolving billing issues promptly. Strong attention to detail and numerical accuracy, with a commitment to maintaining confidentiality and upholding the highest standards of integrity in financial transactions. Prepares and distributes statements to customers while maintaining comprehensive, accurate records. Accustomed to answering questions, providing information and resolving concerns. Good communication, organizational and multitasking abilities.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Medical Biller
Sherloq Solutions
Miami, FL
12.2022 - Current
- Applied HIPAA privacy and security regulations while handling patient information.
- Developed strong professional rapport with vendors and clients.
- Assessed billing statements for correct diagnostic codes and identified problems with coding.
- Performed insurance verification, pre-certification and pre-authorization.
- Compiled and processed data for billing purposes utilizing billing software programs.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Researched discrepancies between billed charges and payments received from insurance companies or other third party payers.
- Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
- Reviewed engine assigned codes and modifiers to update and verify accuracy.
- Expedited payments by verifying accuracy and currency of vendor information.
- Provided training and support to new staff members regarding billing processes.
- Reviewed patient insurance information to ensure accuracy and completeness of claims submission.
- Assisted with collection efforts as needed including contacting patients via phone, mail or email for collection of past due balances due to insurance denials or patient responsibility amounts owed.
- Reviewed claims for coding accuracy.
Insurance Sales Agent
Allstate Insurance Co
Hialeah, FL
11.2020 - 12.2022
- Exceeded company sales goals for new policies.
- Upsold products to policyholders and potential new clients.
- Offered policy guidance and management to promote asset protection.
- Provided leadership and training for new agents regarding industry best practices and company policies.
- Engaged customers and provided high level of service by carefully explaining details about documents.
- Analyzed customer needs and provided best options, upselling products and services.
- Skillfully and patiently explained coverage options to potential policyholders, answering any questions or concerns.
- Drove client retention by increasing savings opportunities and identifying premium discounts.
Costumer Services Representative
SHERLOQ Solutions
Miami, FL
08.2018 - 11.2020
- Persuade customers to pay amounts due on credit accounts.
- Collects accounts in compliance with all applicable regulation and internal performance standards in order to meet personal and team goal objective.
- Collect and deposit money into accounts, disburse funds from cash accounts to pay bills or invoices, keep records of collections and disbursements, and ensure accounts are balanced.
- Operate office equipment, such as fax machines, copiers, or phone systems and arrange for repairs when.
- Answer telephones and give information to callers, take messages, or transfer calls to appropriate individuals.
- Collect insurance information from patients and update accounts with the correct and proper information.
Collector
SHERLOQ Solutions
Tampa, FL
04.2017 - 07.2018
- Locate and notify customers of delinquent accounts by mail, telephone, or personal visits to solicit payment.
- Arrange for debt repayment or establish repayment schedules, based on customers' financial situations.
- Receive payments and post amounts paid to customer accounts.
- Persuade customers to pay amounts due on credit accounts, damage claims, or nonpayable checks, or to return merchandise.
- Locate and monitor overdue accounts, using computers and a variety of automated systems.
- Answer customer questions regarding problems with their accounts.
Education
Bachelor of Science - Nursing
Miami Regional University
Miami, FL07-2026
Career Diploma - Medical Billing And Coding
Penn Foster Career School
Scranton, PA09-2025
Skills
- Insurance sales strategy
- Client account management
- Policy adjustment knowledge
- Policy management expertise
- Customer follow-up
- Communication
- Leadership
- People skills
- Data management
- Medical coding
- Claims processing
- Insurance verification
- Insurance claims processing
- Claims review
- Critical thinking
- Medical claims submission
- Billing process management
Languages
Bilingual Spanish / English
Certification
- Certified Revenue Cycle Specialist (CRCS)
Timeline
Medical Biller
Sherloq Solutions
12.2022 - Current
Insurance Sales Agent
Allstate Insurance Co
11.2020 - 12.2022
Costumer Services Representative
SHERLOQ Solutions
08.2018 - 11.2020
Collector
SHERLOQ Solutions
04.2017 - 07.2018
Bachelor of Science - Nursing
Miami Regional University
Career Diploma - Medical Billing And Coding
Penn Foster Career School