Claudia Perez
Garden Grove,CA
Summary
Proficient claims associate skilled in handling high volumes of claims. Processes adjustments based on identifiable liability and compensability. Supports work of senior team members by organizing documentation and assisting on complex cases.
Overview
7
7
years of professional experience
Work History
Insurance Claims Processor
Avanti Hospitals
Norwalk, CA
11.2019 - 03.2021
- Reviewed insurance policies to determine coverage and eligibility for claims processing.
- Submitted claims forms with all necessary documents to insurance companies for payment authorization.
- Verified accuracy of information on claim forms before submission.
- Processed incoming mail and faxes related to insurance claims.
- Maintained accurate records of all processed claims using database management software.
- Researched discrepancies between submitted insurance claims and policy terms.
- Collected additional documentation as required by the insurer prior to processing a claim.
Billing Specialist
Statim LLC
Brea, CA
09.2016 - 08.2019
- Calculated billing charges, prepared and submitted claims to insurance companies.
- Verified insurance coverage and identified third-party payers for billing purposes.
- Monitored accounts receivable activity to ensure timely payment of invoices.
- Resolved discrepancies between customers' remittances and invoices received.
- Answered customer inquiries regarding billings, payments, account status.
- Investigated incorrect billings and processed refunds as necessary.
- Maintained accurate records of collections, adjustments and denials in the system.
Medical Billing Specialist
Advanced Dermatology Center
Newport Beach, CA
04.2014 - 06.2016
- Provided customer service support to patients who had questions about their bills or payments due.
- Assisted with the reconciliation of accounts receivable ledgers at month-end close process.
- Updated patient accounts with information obtained from internal departments or external sources.
- Processed credit card payments from patients in accordance with office policy.
- Reviewed patient records for accuracy and completeness of information in medical billing system.
- Created and processed claims to third-party payers using specific coding guidelines.
- Verified the accuracy of claim data prior to submission to insurance carriers.
Education
CPR
National CPR Foundation
07-2024
Medical Billing
American Career College
Anaheim, CA09-2009
Associate of Science - General Education
Fullerton College
Fullerton, CA03-2001
Some College (No Degree) - Psychiatric Technician
Cypress College
CypressSkills
- Verbal Communication
- Policy Interpretation
- Claims review
- Transactions reconciliation
- Payments posting
- Allocating claims
Languages
Spanish
Professional
Timeline
Insurance Claims Processor
Avanti Hospitals
11.2019 - 03.2021
Billing Specialist
Statim LLC
09.2016 - 08.2019
Medical Billing Specialist
Advanced Dermatology Center
04.2014 - 06.2016
CPR
National CPR Foundation
Medical Billing
American Career College
Associate of Science - General Education
Fullerton College
Some College (No Degree) - Psychiatric Technician
Cypress College
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