Claudia Rondan
Glendale,AZ
Summary
Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals.
Overview
18
18
years of professional experience
Work History
Admitting Lead
John C Lincoln Hospital
05.2021 - Current
- Supervise and coordinate the registration staff's tasks and responsibilities across shifts, ensuring a smooth transition and seamless operations.
- Participate in departmental meetings to foster open communication, build strong relationships, and develop effective public relations skills.
- Support the recruitment process by reviewing resumes, conducting interviews, and identifying top talent to join the team.
- Facilitate employee training and development within the department, partnering with market trainers to ensure continuous learning and growth.
- Manage the department schedule, handle sick leave calls, and make necessary adjustments.
- Greet patients and visitors, provide customer service, and answered inquiries.
- Assist in the registration process by obtaining patient demographic information and insurance information.
- Maintain confidentiality of all patient information according to HIPAA regulations.
- Provide support during emergency situations within the admitting area.
- Oversee Act Ideas and Fun Committee, focusing on team recruitment, innovative idea generation, and effective team communication.
Admitting Representative
John C Lincoln Hospital
11.2019 - 05.2021
- Maintained a high level of quality customer service when interacting with patients, families, visitors, and medical staff members.
- Created new accounts in hospital database systems.
- Managed financial counseling for uninsured or underinsured patients including providing assistance with applications for public aid program such as Medicaid.
- Assisted in the registration process by obtaining patient demographic information and insurance information.
- Confirmed admission of patients transported by ambulance and issued identification wristbands and labels.
- Confirmed patient's insurance coverage and collected applicable deductibles, coinsurance and copays.
Housekeeper
John C Lincoln Hospital
05.2019 - 11.2019
- Disinfected telephones, light switches and other frequently touched objects.
- Swept and mopped floors, vacuumed carpets and rugs, dusted furniture, wiped down surfaces.
- Ensured that all health standards were met during cleaning operations.
- Followed safety procedures when handling hazardous materials.
- Updated bedding and sanitized sleeping areas, ensuring a clean and comfortable environment.
Claims Customer Service Representative
Care1st Health Plan of Arizona
05.2014 - 04.2016
- Responded to inbound and outbound calls from physicians and facilities to discuss and explain health insurance benefits to members, providing clear and concise explanations and resolving any queries or concerns in a professional and courteous manner.
- Accurately processed CMS 1500 claims in accordance with insurance company contracts and member benefit plans, ensuring compliance with regulatory requirements and timely reimbursement.
- Proactively identified and efficiently resolved a range of medical billing, coding and insurance discrepancies, including reversals and recoupments, ensuring accurate reimbursement and maintaining a high level of data integrity.
- Consistently exceeded productivity standards by maintaining a minimum production rate of 98%, as established by Care1st, demonstrating high efficiency and dedication to meeting performance goals.
Claims Analyst
Care1st Health Plan of Arizona
09.2013 - 05.2014
- Accurately processed CMS 1500 claims in accordance with insurance company contracts and member benefit plans, ensuring compliance with regulatory requirements and timely reimbursement.
- Proactively identified and efficiently resolved a range of medical billing, coding and insurance discrepancies, including reversals and recoupments, ensuring accurate reimbursement and maintaining a high level of data integrity.
- Consistently exceeded productivity standards by maintaining a minimum production rate of 98%, as established by Care1st, demonstrating high efficiency and dedication to meeting performance goals.
Member Service Representative
Care1st Health Plan of Arizona
04.2007 - 09.2013
- Coordinated transportation services for eligible members.
- Approved requests for ambulance transportation services.
- Logged and tracked incoming phone calls in a digital tracking system.
- Supported members with: primary care physician changes, finding in-network providers, submitting grievances.
- Supported members and providers by clarifying prior authorization statuses.
- Supported members with billing questions and issues resolution.
- Supported members with understanding their pharmacy coverage and addressing medication issues.
- Collaborated with Director and Leads on various additional tasks and projects as assigned.
Education
High School Diploma -
North High School
05-2003
Skills
- Computer Skills:
- Microsoft office: Word, Excel, Outlook, PowerPoint
- Medical Software Skills:
- Database management: AWD, MHC, MedAccess, Advantica
- Coding and billing: EncoderPro
- Electronic health records: Epic, Phycon, NDB
- Online portals: AHCCCS online, Noridian, Ipas
- Medical Billing and Coding Skills:
- Coding system: CPT, HCPC, ICD-9, ICD-10,
- Medical Terminology:
- Billing guidelines and regulations
- Pricing and reimbursement knowledge
- Provider contract management
Languages
English
Professional
Spanish
Professional
Education and Training
other
Timeline
Admitting Lead
John C Lincoln Hospital
05.2021 - Current
Admitting Representative
John C Lincoln Hospital
11.2019 - 05.2021
Housekeeper
John C Lincoln Hospital
05.2019 - 11.2019
Claims Customer Service Representative
Care1st Health Plan of Arizona
05.2014 - 04.2016
Claims Analyst
Care1st Health Plan of Arizona
09.2013 - 05.2014
Member Service Representative
Care1st Health Plan of Arizona
04.2007 - 09.2013
High School Diploma -
North High School
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