Bianca Ortega
Modesto,CA
Summary
Hello, I am a caring, positive Customer Service Representative. Organized and friendly with the ability to interact positively with staff and members. Highly-motivated employee with desire to take on new challenges. Strong work ethic, adept at working effectively unsupervised and quickly mastering new skills. Adheres to procedures to comply with HIPPA regulations. Managed professional tasks, utilized electronic medical records systems.
Overview
12
12
years of professional experience
Work History
Customer Service Representative
Health Plan of San Joaquin and Mountain Valley Health Plan
Modesto, CA
09.2024 - Current
- Provided information on benefits, eligibility, claims, authorizations and other related items over the phone and in person.
- Researched and resolved issues related to claims and authorizations; monitored progress.
- Researched and resolved complex eligibility issues; monitored progress.
- Created required documentation, including but not limited to call logs and other tracking systems.
- Provided strong oral and written communication skills, with ability to express self clearly and professionally, and documented according to standards.
- Provided strong listening skills, with the ability to accurately receive and understand messages.
- Basic problem solving and analytical skills, including the ability to perform routine analysis and solve problems using identified data and information.
- Arithmetic skills.
- Knowledge of contact center systems.
- Conflict resolution skills, with the ability to use tact and diplomacy to diffuse emotional situations.
- Skills in Windows, Word, Excel and Outlook.
- Ability to navigate multiple systems and resources simultaneously.
- Ability to handle confidential information with appropriate discretion.
- Ability to work independently and as part of a team.
- Ability to read, understand and apply complex written guidelines, instructions and other materials.
Medical Clerk
Aspen Family Medical
Modesto, CA
10.2013 - 05.2023
- Organized, filed, and retrieved patient charts and documents.
- Answered telephones promptly, courteously, and efficiently responding to inquiries from patients and other healthcare professionals.
- Maintained databases of patient information including contact details, allergies, medications, treatments, test results.
- Assisted physicians with administrative tasks such as scheduling appointments and organizing medical reports.
- Greeted patients in a friendly and professional manner when they arrived at the office or clinic.
- Collected co-payments from patients at time of service and documented payments accurately in the database system.
- Performed general office duties such as photocopying documents, faxing forms to other offices.
- Reviewed and entered patient medical records into electronic health record system.
- Assisted in training new employees on the use of office equipment and proper filing techniques.
- Prepared daily reports on patient visits for the physician's review.
- Demonstrated strong organizational skills while managing multiple tasks simultaneously.
- Organized patient charts, gathering medical histories, lab results and consents.
- Retrieved medical charts for healthcare staff for filing in medical records.
- Vital signs, injections and assisting with minor procedures
Education
High School Diploma -
Stone Coast Academy
Miami, FL02-2016
Skills
- Referral supervision
- Medical terminology
- Electronic health records
- Patient charting
- Interpersonal skills
- Customer service
- Insurance verification
- HIPAA compliance
- Billing and coding
- Prescription management
- Bilingual (Spanish)
- Data entry (10-key)
- Microsoft Office proficiency
- Typing speed (40 WPM)
- Microsoft office
Education and Training
other
Timeline
Customer Service Representative
Health Plan of San Joaquin and Mountain Valley Health Plan
09.2024 - Current
Medical Clerk
Aspen Family Medical
10.2013 - 05.2023
High School Diploma -
Stone Coast Academy