Crystal Soto Hernandez

• Greeted patients and visitors, ensuring a welcoming atmosphere at front desk.
• Scheduled appointments using electronic health record system, optimizing daily patient flow.
• Managed patient check-in and check-out processes, enhancing operational efficiency.
• Answered phone inquiries, providing accurate information regarding services and procedures.
• Coordinated communications between medical staff and patients, improving service delivery.
• Handled insurance verification processes, ensuring smooth billing operations for services rendered.
• Maintained a clean and welcoming reception area to ensure a positive first impression for all visitors to the medical facility.
• Helped patients complete necessary medical forms and documentation.
• Maintained current and accurate medical records for patients.
• Verified and updated demographic and other personal information for clients with respect to personal boundaries when asking for important details.
• Managed multi-line phone system and pleasantly greeted patients.
• Completed clerical duties and tasks for clinic administration.
• Contributed to a positive work environment through effective teamwork and collaboration with colleagues in both front office and clinical roles.
• Checked patient insurance, demographic, and health history to keep information current.

Oversaw surgery scheduling processes and facilitated patient acquisition of required surgical clearances to enhance operational efficiency.

• Processed medical claims and invoices for a high-volume healthcare facility, ensuring accuracy and adherence to billing guidelines

• Verified patient insurance coverage and obtained necessary authorizations for medical procedures

• Utilized electronic health record (EHR) systems to input patient information, update billing records, and generate reports

• Followed up with insurance companies regarding claim denials or discrepancies, resolving issues in a timely manner

• Maintained strict confidentiality of patient information in compliance with HIPAA regulations

• Managed accounts receivable by tracking outstanding payments, contacting patients for payment arrangements, and initiating collections when necessary

• Developed strong relationships with insurance company representatives to facilitate smooth claims processing and resolve any disputes or delays

• Verified patient insurance information to guarantee accuracy and completeness of claims submissions.
• Enhanced customer satisfaction through effective problem resolution and expert service delivery.
• Executed data compilation and processing for billing operations using advanced billing software programs.
• Monitored and analyzed government regulations to ensure compliance in healthcare reimbursement processes.
• Developed and implemented comprehensive policies and procedures to enhance operational efficiency.
• Compiled and analyzed reports to monitor payments owed by insurance companies and third parties.
• Managed payer accounts to ensure timely and accurate processing.
• Processed and submitted electronic claims to multiple insurance carriers.
• Managed incoming calls related to billing inquiries from patients and providers in a professional manner.
• Demonstrated effective communication and interpersonal skills in various situations.
• Analyzed discrepancies between billed charges and payments received from insurance companies.
• Collaborated with third-party payers to streamline reimbursement processes.
• Executed follow-up activities on unpaid claims with insurance companies and third-party payers.
• Communicated effectively via phone and written correspondence to support team objectives. Assisted in maintaining clear and concise communication channels. Facilitated information exchange to ensure smooth operations.
• Assisted in collection efforts by contacting patients through phone, mail, or email as needed.
• 1. Elevated Action: Managed collection of overdue balances resulting from insurance denials and patient responsibilities.
• Generated monthly aging reports to facilitate identification of delinquent accounts for management review.
• Oversaw adherence to HIPAA guidelines in the management of confidential patient information.
• Compiled comprehensive financial reports in response to management requests.
• Executed timely and accurate processing of refund requests in accordance with established protocols.
• Executed comprehensive appeals for denied claims, ensuring thorough documentation and compliance.
• Facilitated communication with insurance representatives to expedite claims processing.
• Assisted in processing claims to support timely resolutions. Helped maintain accurate records of claims for efficient tracking. Collaborated with team members to address client inquiries regarding claims status.
• Verified accuracy and completeness of patient and insurance account information.
• Ensured compliance with HIPAA privacy and security regulations while managing patient information.
• Facilitated communication with insurance providers to verify coverage details and secure billing authorization.
• Evaluated claims to ensure coding accuracy and compliance with industry standards.
• Assisted in entering details into accounts and tracking payments. Supported distribution of financial data to relevant accounts and prepared basic reconciliations.
• Utilized EMR software to accurately post payments for medical services.
• Processed and submitted insurance claims to ensure timely reimbursement.
• Inputted procedure and diagnosis codes along with patient information into billing software.
• Assisted in processing invoices and managing accounts. Supported team members in maintaining accurate financial records. Helped resolve discrepancies in billing and account statements.
• Oversaw collection, posting, and management of patient account payments.
• Executed invoice payment processing and maintained accurate records in account database.
• Analyzed past due invoices and delinquent accounts to enhance revenue generation.
• Assisted in managing unpaid accounts to facilitate timely resolution. Supported efforts to track outstanding balances and communicate with clients. Aided in maintaining accurate records of account statuses.
• Executed submission of appeals through provider portals and direct phone communication.
• Facilitated seamless communication between patient billing teams and insurance carriers.
• Oversaw reimbursement processes from managed care networks and insurance carriers to ensure accuracy.
• Negotiated contract rates to optimize financial agreements.
• Administered billing software by updating rate change cash spreadsheets and current collection reports.
• Verified claims coding accuracy in compliance with ICD-10 standards.
• Executed precise input of procedure codes, diagnosis codes, and patient information into billing software.
• Executed generation of up-to-date invoices to ensure accurate billing processes.
• Oversaw payment processing, invoicing, and collections operations.
• Addressed customer inquiries, ensuring high satisfaction levels were maintained.
• Executed insurance verification processes for pre-certification and pre-authorization.
• Calculated postage requirements by weighing envelopes containing statements and affixed appropriate postage.
• Streamlined payment processes by verifying accuracy and currency of vendor information.
• Engaged in workshops, seminars, and training classes to enhance industry knowledge and expertise.
• Assisted in compliance with local and federal regulations. Supported teams in understanding regulatory requirements. Aided in maintaining documentation for regulatory audits.

• Processed medical claims using advanced billing software to ensure timely reimbursements.
• Reviewed patient accounts for accuracy, correcting discrepancies to maintain compliance with policies.
• Collaborated with healthcare providers to resolve billing inquiries and improve communication channels.
• Implemented coding updates in accordance with regulatory changes to enhance billing efficiency.
• Reviewed patient insurance information to ensure accuracy and completeness of claims submission.
• Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
• Submitted electronic claims to various insurance carriers.
• Answered incoming calls regarding billing inquiries from patients and/or providers in a professional manner.
• Researched discrepancies between billed charges and payments received from insurance companies of other third party payers
• Performed follow up activities on unpaid claims with insurance companies or other third party payers by phone or written correspondence.
• Ensured compliance with HIPAA guidelines when handling confidential patient information.
• Prepared detailed financial reports as requested by management team.
• Communicated with insurance representatives to complete claims processing or resolve issues.
• Reviewed account information to confirm patient and insurance information is accurate and complete.
• Applied HIPAA privacy and security regulations while handling patient information.
• Contacted insurance providers to verify insurance information and obtain billing authorization.
• Reviewed claims for coding accuracy.
• Input details into accounts and tracked payments.
• Distributed or posted financial data to appropriate accounts and prepare simple reconciliations.
• Leveraged EMR software to post payments received for medical services.
• Submitted claims to insurance companies.
• Entered procedure codes, diagnosis codes and patient information into billing software to facilitateinvoicing and account management.