Cristina Vasquez Alvarez
Wilmington,CA
Summary
An organized and motivated individual seeking career advancement as a Credentialing Coordinator. Detail oriented with great communication skills to work well with insurances and regulations. Maintaining appropriate communication with individual
health professionals. Knowledgeable in government funded programs such as LAPHP, HMO and PPO networks. Work well under pressure and adaptable to the company’s needs.
Overview
3
3
years of professional experience
1
1
Certification
Work History
Insurance Biller/Tracer
West Coast Dental Study Club, Jin Y. Kim & Jin Y. Kim, Dds, Mph, Ms
Torrance, CA
04.2024 - Current
- Submitted pre-authorization requests for government funded plans and HMO’s
- Processed insurance claims and verified patient information for accuracy.
- Assisted in coordinating billing procedures to improve efficiency and reduce errors.
- Collaborated with staff to resolve discrepancies in services being billed.
- Learned software systems for electronic claims submissions and payment tracking.
- Resolved complex billing issues by collaborating with internal departments and external agencies as needed.
- Achieved timely resolution of denied or underpaid claims through thorough research and concise appeals submissions.
- Contributed to company growth by identifying opportunities for improvement within the billing department''s workflows.
- Collaborated with healthcare professionals to obtain necessary documentation for claim submission and payment.
Credentialing Coordinator
West Coast Dental Study Club, Jin Y. Kim & Jin Y. Kim, Dds, Mph, Ms
Torrance, CA
10.2022 - 03.2024
- Coordinated provider credentialing processes ensuring compliance with regulatory standards.
- Managed documentation for new and existing dental professionals, enhancing accuracy and accessibility.
- Collaborated with insurance companies to verify provider credentials and maintain up-to-date records.
- Conducted regular audits of credentialing files to ensure adherence to organizational policies.
- Developed and maintained relationships with healthcare organizations for efficient information exchange.
- Provided support in the development of credentialing policies and standard operating procedures.
- Assisted with special projects as needed, demonstrating adaptability and commitment to the success of the organization.
- Strengthened relationships with external agencies by responding promptly to verification requests and inquiries regarding providers'' credentials.
- Reduced errors in documentation by thoroughly auditing provider files for completeness and accuracy.
- Conducted primary source verifications such as background checks and board certifications.
- Prepared records for site visits and file audits.
- Assisted in training new staff on credentialing protocols and software systems.
Orthodontic Biller/Tracer
West Coast Dental Study Club, Jin Y. Kim & Jin Y. Kim, Dds, Mph, Ms
Torrance, CA
05.2022 - 09.2022
- Processed patient billing and insurance claims efficiently, ensuring accuracy in submissions.
- Utilized dental software to maintain up-to-date patient accounts and billing records.
- Collaborated with healthcare providers to verify insurance coverage and resolve discrepancies.
- Implemented streamlined billing procedures to enhance operational efficiency within the practice.
- Monitored outstanding accounts receivable, following up on overdue payments systematically.
- Assisted patients with billing inquiries, providing clear explanations of charges and payment options.
- Kept all patient information secure and confidential.
Customer Service Representative
West Coast Dental Study Club, Jin Y. Kim & Jin Y. Kim, Dds, Mph, Ms
Torrance, CA
02.2022 - 04.2022
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Trained new staff on customer service protocols, enhancing team efficiency and service quality standards.
- Trained new Customer Service Representatives on company policies, procedures, and best practices.
Education
Pending Associates - Communication Studies
Los Angeles Harbor College
Wilmington, CAPending Bachelors - Business Administration And Communication Studies
California State University, Fullerton
Fullerton, CAHigh School Diploma -
Phones Banning High School
Wilmington, CA06.2019
Skills
- Fluent in English and Spanish
- HIPAA compliance
- Claim submission
- Patient confidentiality
- Professionalism and ethics
- Time management
- Attention to detail
- Adaptability and flexibility
- Verbal and written communication
- Microsoft office
Certification
CDE Biliteracy Seal Award
Languages
Spanish
Native or Bilingual
Timeline
Insurance Biller/Tracer
West Coast Dental Study Club, Jin Y. Kim & Jin Y. Kim, Dds, Mph, Ms
04.2024 - Current
Credentialing Coordinator
West Coast Dental Study Club, Jin Y. Kim & Jin Y. Kim, Dds, Mph, Ms
10.2022 - 03.2024
Orthodontic Biller/Tracer
West Coast Dental Study Club, Jin Y. Kim & Jin Y. Kim, Dds, Mph, Ms
05.2022 - 09.2022
Customer Service Representative
West Coast Dental Study Club, Jin Y. Kim & Jin Y. Kim, Dds, Mph, Ms
02.2022 - 04.2022
Pending Associates - Communication Studies
Los Angeles Harbor College
Pending Bachelors - Business Administration And Communication Studies
California State University, Fullerton
High School Diploma -
Phones Banning High School