Beatriz Avelar
Tyler,United States
Summary
Personable Enrollment Specialist with talents in customer service. Easily adapts to changing assignments and multiple priorities. Excellent telephone and email skills. Consistently remains calm in stressful circumstances. Ethical Enrollment Specialist with a multi-year track record of providing outstanding customer support in industry enrollment services. Flexible and detail-oriented to learn quickly and meet department deadlines and goals.
Overview
6
6
years of professional experience
Work History
Enrollment Specialist
Strive
, United States
12.2022 - Current
- Make outbound calls to prospective patients to educate them on Strive's holistic care model
- Understand patients' needs, demonstrating empathy for individual needs
- Performed data entry and maintained accurate records of patient enrollment information.
- Maintained up-to-date knowledge of changes in college policies, procedures, regulations, and fees.
- Conducted comprehensive research and data analysis to support strategic planning and informed decision-making.
- Recognized by management for providing exceptional customer service.
Commercial Collections
Fresenius Medical Care
04.2021 - 07.2022
- Monitor the patients accounts receivable and identify overdue accounts
- Contact customers with overdue accounts and attempt to either collect the overdue amount from insurance or patients
- Use ability to review claims, contact insurance companies to get patient claims resolve
- Maintain records of contacts and attempted contacts with delinquent account customers as well as records of any payments collected from the customer
- Gather and interpret business requirements, verify accuracy and completeness of requirements to source documents
- Analyze data trends and utilizes correct ICD9, CPT and HCPCS coding methods to determine the proper code
- Submit regular reports on the status of unpaid accounts and any repayment progress.
Data Analyst
Centene Corporation
10.2018 - 12.2019
- Perform operational and financial audits related to processes and systems impacting claims payment accuracy
- Gather and interpret business requirements, verify accuracy and completeness of requirements to source documents
- Analyze data trends and utilizes correct ICD9, CPT and HCPCS coding methods to determine the proper code.
- Reviewed customer claims, identified discrepancies and determined appropriate course of action.
- Managed escalated cases involving high-value claims or multiple parties involved.
- Assisted in developing new protocols for improving claim processing accuracy rates.
Scheduling Specialist
CHRISTUS Trinity Mother Frances Health System
04.2018 - 10.2018
- Created reports related to appointment scheduling activities as requested by management.
- Answered incoming calls, scheduled patient appointments and confirmed existing appointments.
- Performed data entry into computer systems for tracking purposes.
- Evaluated medical records for accurate code assignment based on ICD-10 guidelines.
- Researched and assigned appropriate ICD-10 codes based on documentation in the patient's medical record.
- Assigned appropriate ICD-10 codes for all diagnoses and procedures related to Scheduled Procedure.
Education
High School Diploma -
John Tyler High School
Tyler, TX06-2010
Some College (No Degree) - CBCS
Tyler Junior College
TylerSkills
- Budget Planning
- Deadline Management
- Customer service background
- Marketing knowledge
- Customer service expertise
- Strong Organization
- Data entry skills
- Spanish translation
- Claims Evaluation
- Call Center Operations
- Payment Processing
- Strong interpersonal skills
Timeline
Enrollment Specialist
Strive
12.2022 - Current
Commercial Collections
Fresenius Medical Care
04.2021 - 07.2022
Data Analyst
Centene Corporation
10.2018 - 12.2019
Scheduling Specialist
CHRISTUS Trinity Mother Frances Health System
04.2018 - 10.2018
High School Diploma -
John Tyler High School
Some College (No Degree) - CBCS
Tyler Junior College
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