Summary
Knowledgeable and dedicated with extensive experience in the healthcare industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients and staff. Hardworking team player with expertise in completing various clerical tasks and offering staff support. Responsible, punctual and productive professional when working with little to no supervision. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Authorized to work in the US for any employer.
Overview
6
6
years of professional experience
Work History
Medical Office Manager
Corpus Christi Chiropractic Associates
01.2020 - 03.2023
- Created and managed electronic patient records, encompassing data entry and administrative functions related to insurance, billing, and accounts receivable.
- Front desk; checking patients in and out, handle multiple phone lines and emails regarding patients, and provided proper scheduling of patients, ensuring timely, and effective allocation of resources.
- Assisted with regulatory issues such as compliance, Coordinated office events and meetings for staff and Hired, managed, trained staff, established and monitored goals, conducted performance reviews for staff.
- Implemented onboarding for new employees, which enabled each to effectively learn tasks and job duties also implemented organizational policies and procedures.
- Request, file, submit and notarize medical records and affidavits, Handle phone inquiries and insurance verification.
- Assessed processes and procedures, complying with OSHA, and HIPAA regulations, Conduct and/or review office inventory.
- Communicated effectively with staff members, physicians, and patients, employing active listening and interpersonal skills.
Commercial CSR
Results Companies
06.2019 - 01.2020
- Answered incoming phone calls to articulate product value to prospective customers and support current policyholders.
- Documented customer interactions and transactions for accurate, up-to-date records.
- Fielded customer complaints, escalating complex issues to management for resolution.
- Met customer call guidelines for service levels, handle time and productivity.
- Maintained up-to-date knowledge of product and service changes.
Billing Specialist
SpineCare Medical Group
02.2019 - 07.2019
- Prepared and submitted monthly billing reports to management for financial overview.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement, and verified invoices to secure accuracy of billing information.
- Communicated with insurance companies to research and resolved coding discrepancies.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services.
Medicare Customer Service Representative
Alorica
07.2018 - 01.2019
- Investigated and resolved customer inquiries and complaints quickly.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Met customer call guidelines for service levels, handle time and productivity.
- Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
- Investigated and resolved accounting, service and delivery concerns.
Medical Assistant
Psychiatric Consulting Services
10.2018 - 12.2018
- Sanitized, restocked, and organized medical equipment.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Performed medical records management, including filing, organizing and scanning documents.
- Collected and documented patient medical information such as blood pressure and weight.
Health Advisor
North San Antonio Family Medicine
05.2018 - 06.2018
- Sanitized, restocked, and organized exam rooms and medical equipment.
- Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
- Obtained client medical history, medication information, symptoms, and allergies and documented patient medical information such as blood pressure and weight, measure patient pulse oximetry.
- Performed medical records management, including filing, organizing and scanning documents.
- Called and faxed pharmacies to submit prescriptions and refills. Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Assisted with routine checks and diagnostic testing by collecting and processing specimens, and prepared lab specimens for diagnostic evaluation.
- Explained procedures to patients to reduce anxieties and increase patient cooperation. Taught patients about medications, and after care plan instructions if any given.
- Kept medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted, Updated inventory, expiration and vaccine logs to maintain current tracking documentation.
- Assisted physicians with minor procedures, including preparing room and sterilizing instruments. Completed EKGs and other tests based on patient presentation in office.
Patient Service Advocate
UnitedHealth Group
10.2016 - 06.2017
- Provided exceptional customer service to patients, via telephone and through email, answering questions and addressing concerns. Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Built and maintained positive working relationships with customers and staff. Resolved customer complaints using established follow-up procedures.
- Investigated claims denials and appeals. Located errors and promptly refiled rejected claims. Followed document protocols to safeguard confidentiality of patient records.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
- Analyzed complex Explanation of Benefits forms to verify correct billing of medical providers and facilities.
- Liaised between patients, medical office staff, billing companies, and pharmacies.
Education
Medical Assistant -
12.2018
- Relevant Coursework: Medical Terminology & Medicine History
- Professional Development: Medical Office
- Learn to use medical equipment, take vital signs, collect blood and specimen samples and prepare/give injections.
- On job training
- Learn communication, interpersonal skills and bed side manner.
Medical Billing And Coding Specialist
03.2010
- Relevant Coursework: Medical Billing & Medical Coding
- Professional Development: Medical Office, Professional Office
- Learn Medical terminology, Medical billing protocol and procedures, Medical codes, EMR systems, Billing systems and Windows programs
High School Diploma -
06.2009
Skills
- Medical Terminology Knowledge, Medical Coding Knowledge and Insurance/Benefit Verification
- Administrative Support, Clerical Support, Best Practices and Standards, Continuous Improvement Process
- Customer Service, Active Listening, Effective Multitasking and Persuasive Communication
- Microsoft Word, PowerPoint and Excell/Computer Proficiency
- Credit Card Payment Processing, Electronic Filing System and Statement Itemization
- Patient Identification, HIPAA Compliance and Insurance Claim Requirements
- Critical Thinking
- Data Entry, 10-Key Data Entry and Typing Proficiency
- Multi-Line Telephone Operation and Call Center Operations
- Documentation and Research
- Reading Comprehension, EOB Comprehension, and Insurance Comprehension
Timeline
Medical Office Manager - Corpus Christi Chiropractic Associates
01.2020 - 03.2023
Commercial CSR - Results Companies
06.2019 - 01.2020
Billing Specialist - SpineCare Medical Group
02.2019 - 07.2019
Medical Assistant - Psychiatric Consulting Services
10.2018 - 12.2018
Medicare Customer Service Representative - Alorica
07.2018 - 01.2019
Health Advisor - North San Antonio Family Medicine
05.2018 - 06.2018
Patient Service Advocate - UnitedHealth Group
10.2016 - 06.2017
Brightwood - Medical Assistant,
Southern Careers Institute - , Medical Billing And Coding Specialist
Foy H. Moody High School - High School Diploma,
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