Highly organized, detail-oriented worker, with a drive to exceed expectations. Ability to analyze data, develop strategies, and provide solutions to complex problems. Seeking to leverage skills and knowledge to contribute to team success.
Overview
14
14
years of professional experience
Work History
CLAIMS PROCESSOR
Conduent - Remote
10.2024 - Current
Accurately reviewed insurance policies, endorsements, and supporting documents to verify coverage eligibility, and determine claim validity.
Processed a high volume of medical claims, with attention to regulatory compliance and provider billing guidelines.
Interpreted and validated detailed medical documentation, ensuring accurate data entry, and timely claim resolution.
Applied knowledge of ICD and CPT codes to confirm procedure accuracy before calculating reimbursement amounts.
Collaborated cross-functionally with internal teams to escalate discrepancies, and resolve denied or pending claims.
Maintained HIPAA compliance and safeguarded sensitive health information while working remotely.
Consistently met or exceeded productivity and quality targets in a deadline-driven environment.
OFFICE ASSISTANT
ATX Lawn Sharks
Austin
02.2022 - 09.2024
Interact with customers by phone, email, or in-person to provide information.
Manage information that comes in through the website, company email, and texts.
Ordering material and working closely with the owner to schedule jobs and crews.
Process billing invoices and statements.
ACCOUNTS EXAMINER II
Texas Comptroller of Public Accounts - Remote
Austin
01.2019 - 04.2021
Analyzing tax return information and identifying/assigning correct forms for processing.
Review, interpret, and entering data for reports sent to the Texas Secretary of State.
Identify/assign taxpayer numbers to imaged Franchise tax documents; classify/deliver electronic Franchise tax documents to Account.
Conducting retrieval and deliver tax/stakeholder documents for internal customers.
Identifying and resolving discrepancies created by invalid data processing or technical issues.
Assist Data Entry section in special projects to ensure we meet deadlines.
Verify and correct inconsistencies as well as entering and updating data.
ACCOUNTS EXAMINER III
Texas Comptroller of Public Accounts
Austin
07.2017 - 09.2018
Basic Sales and Use Tax and Franchise Tax Training.
Researching tax laws, rules and taxpayer account information.
Analyzing Taxpayer's accounts.
Assisted customers with online services and applications.
Processing payments.
I have knowledge and experience with regulations, policies, and procedures.
Appropriately apply and interpret existing law, pending legislation, rules, and procedures within my workplace.
CLAIMS PROCESSOR II
VA Financial Services Center (ATP2)
Austin
01.2015 - 06.2017
Utilize the VA-FSC medical claims processing system which incorporates an Internet authorization application, document processing functionality, optical character recognition (OCR) scanning capability and Plexis Claims Manager (PCM) claims processing software.
Input and validate medical claims data into the PCM application.
Determine the appropriate amount due to the recipient and process all necessary payment transactions.
Analyze and audit any overpayments of claims.
Record and issue letters informing debtors of obligations.
Respond to written and oral vendor inquiries; follow up as needed.
Analyze bulk claims and determine appropriate payment amounts.
Ensure appropriate diagnostic and procedural coding for all HCFA-1500, UB92 and other claim forms.
Prepare claims for payments.
Validate appropriate claim adjustments to resolve payment discrepancies.
Ensure accuracy of information included in VA-FSC vendor file for medical providers.
Interface with VA-FSC activities including mailroom in support of preparation and scanning of paper claims.
FRONT DESK RECEPTIONIST AND MEDICAL RECORDS CLERK
Texas Orthopedics
Austin
12.2012 - 01.2015
Scheduled appointments.
Professionally and courteously verified appointment times with patients.
Assisted in the maintenance of medical charts and/or electronic medical record (filing, Op reports, test results, home care forms).
Adeptly managed a multi-line phone system and pleasantly greeted all patients.
Prepared patient charts accurately and neatly for the clinic.
Scanned medical records in digital format for easy retrieval and accessibility.
Typed patients information and created spreadsheets, verifying them against source documents at different stages during the process.
Gathering patient demographic and personal information.
Issuing medical files to persons and agencies according to laws and regulations.
Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
CUSTOMER SERVICE REP
Texas Auto Center
Austin
05.2013 - 04.2014
Answered customer telephone calls promptly to avoid on-hold wait times.
Collecting payment on past due accounts.
Made payment arrangements with the customer.
Processed payments.
Filed paperwork and new files.
CHECKER
H-E-B
Austin
10.2012 - 01.2013
Greeted customers.
Restocked and organized merchandise in the front lanes.
Offered products.
Processed both cash and card purchases, and returns.
RECEPTIONIST AND SERVICE CASHIER
South Point KIA
Austin
05.2011 - 12.2011
Liaised between the service manager and the service team by greeting customers and answering calls to promote a smooth transition of service functions.
Made temporary tags.
Performed cash, card, and check transactions to complete customer purchases.