Angelica Gomez
San Antonio,Texas
Summary
Dedicated and detail-oriented professional with 12 years of remote experience in the health industry with Medtronic. Seeking to leverage comprehensive expertise and continue to contribute effectively to a dynamic team remotely.
Overview
14
14
years of professional experience
Work History
INSURANCE VERIFICATION SPECIALIST
Medtronic
01.2012 - Current
- Enter and validate data in computer systems, investigating and resolving discrepancies to ensure accurate insurance benefit verification
- Provide eligibility and insurance verification support to sales teams within service level agreements
- Conduct comprehensive insurance benefit verifications, interacting with insurance carriers, patients, and systems to document accurate billing information
- Collaborate with internal and external stakeholders to address patient inquiries and concerns regarding insurance coverage and Medtronic products.
- Utilize Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) proficiently to support daily operations.
ORDER PROCESSING AGENT
Medtronic
01.2010 - 01.2012
- Partnered with sales representatives to process customer orders, submit documents to physician offices, and review charts for insurance approvals
- Facilitated communication with physicians and insurance providers to resolve pending prescriptions and appeals for prior authorizations while maintaining patient confidentiality under HIPPA guidelines
- Maintained excellent written and verbal communication skills to support sales and regional teams.
Education
Diploma -
Thomas Edison High School
San Antonio, TX06.1999
Skills
- Data Entry
- MS Office Suite
- Remote Team Environment
- Detailed-oriented
- Problem-solving abilities
- Strong Interpersonal and Communication Skills
- Attention to Detail
- HIPAA Compliance
- Patient confidentiality
- Communication and Interpersonal Skills
- Coverage and Authorizations
- Insurance Coverage Verification
- Eligibility Determination
Key Achievements
Developed expertise in reading and interpreting medical policies, utilizing insurance benefits information to calculate patient responsibilities.
Proficient in managing various government and commercial insurance plans (PPO, HMO, EPO, POS, Medicare, Medicaid, HRAs), including referral and authorization requirements.
Successfully communicated insurance benefits and financial responsibilities to patients via outbound calls while maintaining patient confidentiality and adhering to HIPPA guidelines.
Demonstrated exceptional customer service skills within a call center and sales environment while adhering to HIPPA privacy and security regulations.
Fostered collaborative relationships with regional and district teams, ensuring efficient claims processing and customer satisfaction.
Timeline
INSURANCE VERIFICATION SPECIALIST
Medtronic
01.2012 - Current
ORDER PROCESSING AGENT
Medtronic
01.2010 - 01.2012
Diploma -
Thomas Edison High School