DANYA GAMEZ
Poplar Grove,IL
Summary
Experienced Medical Claims Processor with a strong track record of building relationships with providers to resolve claim status and denials. Efficiently manages multiple administrative tasks and consistently delivers results. Recognized for meticulous approach and investigative skills, excelling in accurate and efficient claims processing.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Personal Assistant
DHS
Addison, IL
06.2022 - Current
- Built strong relationships with clients to deliver emotional support and companionship.
Online Personal Shopper
Walmart
Rockford, IL
05.2022 - Current
- Placed completed orders in labeled, temperature-appropriate storage pending customer pick up.
- Consistently met deadlines and quality goals for accuracy and timeliness.
- Memorized store layouts and planograms to fulfill orders using shortest, most efficient route.
- Tracked substitutions and informed customers of changes.
- Demonstrated a keen eye for detail in selecting high-quality products that met customers'' exact specifications.
- Collaborated with fellow personal shoppers to exchange insights and best practices for maximizing client satisfaction.
- Implemented efficient inventory
Home Health Aide
Healthcare Plus
Rockford, IL
05.2020 - Current
- Maintained a clean and safe home environment for patients, reducing falls and accidents.
- Performed laundry, grocery shopping and other light housekeeping duties as instructed by client.
- Improved patient well-being by providing compassionate and attentive personal care.
Home Care Aide
Best In-Home Service, Inc.
Northbrook, IL
05.2018 - 11.2020
- Maintained a clean and safe home environment for patients, reducing falls and accidents.
- Performed laundry, grocery shopping and other light housekeeping duties as instructed by clients
- Adapted to ever-changing patient needs, consistently adjusting care plans and strategies in order to provide the highest quality of personalized assistance.
- Provided companionship to patients, fostering positive relationships and emotional wellbeing.
Telephone Sales Representative
Televerde
Phoenix, AZ
01.2012 - 03.2015
- Generated leads with companies for SAP software
- Cultivated inbound sales inquiries to successfully convert leads to sales appointments.
- Asked probing and pertinent questions to understand customers' needs and match individuals to product offerings.
- Developed rapport with customers through active listening and personalized product recommendations.
- Increased sales revenue by consistently meeting and exceeding daily, weekly, and monthly targets.
Medical Claims Examiner
Pima County Health Systems
Tucson, AZ
06.2005 - 02.2009
- Enhanced claim processing efficiency by conducting thorough investigations and maintaining accurate documentation.
- Kept up-to-date on current industry practices, attending workshops and training sessions to continuously improve professional skills.
- Increased productivity by implementing efficient strategies for handling high volumes of medical claims daily.
- Assisted in the training and onboarding of new team members, sharing knowledge and best practices to ensure their success.
- Developed expertise in specialized areas such as workers'' compensation or disability claims management to better serve diverse client needs.
- Reduced errors in claim submissions by meticulously reviewing patient information and verifying insurance eligibility.
- Collaborated with healthcare providers to obtain necessary medical records, ensuring timely and accurate claim adjudication.
- Provided exceptional customer service, addressing concerns from policyholders and answering inquiries related to their claims status.
Billing Manager
Tucson Chiropractic Center
Tucson, AZ
05.2004 - 06.2006
- Reviewed billing problems, researched issues, and resolved concerns.
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
- Trained and mentored staff on procedures, compliance requirements, and collections techniques.
- Collaborated with cross-functional teams to resolve billing-related issues swiftly, minimizing negative impacts on overall operations.
- Reduced errors and discrepancies in invoicing by closely monitoring billing data and conducting regular audits.
- Implemented policies that improved accounts receivable collections, resulting in reduced outstanding balances and increased cash flow.
- Boosted team productivity through effective delegation of tasks, setting performance targets, and providing constructive feedback.
- Worked with customers to develop payment plans and bring accounts current.
Education
Medical Administrative Assistant - Family Medicine
Pima Medical Institute
Tucson, AZ09.2004
High school diploma in General Studies -
Corona High School
Tempe, AZ05.1992
Skills
- Certified in Microsoft
- Personal Assistant Experience
- Time management
- Personal assistant experience
- Claim Denial Resolution
- Customer Service
- Critical Decision-Making
- HIPAA compliance awareness
- Claims Processing Proficiency
- Insurance claims processing
- Professionalism and Ethics
- Medical terms and procedure knowledge
- Medical Terminology Familiarity
- Insurance Verification
- Medical Coding Experience
Certification
- Medical Administrative Assistant, 06/04, Present, Graduated with honors
- First Aid Certification
Timeline
Personal Assistant
DHS
06.2022 - Current
Online Personal Shopper
Walmart
05.2022 - Current
Home Health Aide
Healthcare Plus
05.2020 - Current
Home Care Aide
Best In-Home Service, Inc.
05.2018 - 11.2020
Telephone Sales Representative
Televerde
01.2012 - 03.2015
Medical Claims Examiner
Pima County Health Systems
06.2005 - 02.2009
Billing Manager
Tucson Chiropractic Center
05.2004 - 06.2006
Medical Administrative Assistant - Family Medicine
Pima Medical Institute
High school diploma in General Studies -
Corona High School