Erica Arizmendez
San Antonio,TX
Summary
Self-motivated professional with deep expertise in managing patient billing and insurance claims. Strong background in coding, account reconciliation, and compliance with healthcare regulations. Known for collaborating effectively with teams and adapting to changing needs to achieve optimal results. Reliable and detail-focused, ensuring accurate and timely processing of financial information. Proficient in learning new concepts quickly and efficiently.
Overview
22
22
years of professional experience
Work History
Rideshare Driver
Uber/Lyft
01.2019 - 09.2024
- Picked up riders at designated locations and greeted upon vehicle entry.
- Assisted riders with special needs or accessibility requirements, ensuring their comfort throughout the journey.
- Maintained excellent ratings from passengers by consistently delivering friendly service and timely pickups.
- Kept meticulous records of mileage, expenses, and maintenance tasks for accurate reporting purposes.
- Improved rider satisfaction by maintaining a clean and comfortable vehicle environment.
- Expanded knowledge of local attractions and points of interest to better assist passengers with recommendations or directions when requested.
Business Office Manager
San Antonio Skin & Cancer Clinic
08.2018 - 02.2021
- Developed detailed plans based on broad guidance and direction.
- Improved workflow efficiency by streamlining office processes and implementing new software solutions.
- Managed financial operations for the business, ensuring accurate budgeting and timely invoice processing.
- Updated reports, managed accounts, and generated reports for company database.
- Contributed to a successful annual audit by preparing thorough documentation in accordance with regulatory requirements.
- Used industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty.
- Enhanced office operations efficiency by streamlining filing systems and digitizing essential records.
- Developed and enforced office policies to ensure compliance with industry regulations, maintaining high standard of operational integrity.
- Coordinated with IT department to resolve technical issues swiftly, minimizing downtime and maintaining operational continuity.
- Worked flexible hours across night, weekend, and holiday shifts.
- Demonstrated strong organizational and time management skills while managing multiple projects.
- Established workflow processes, monitored daily productivity, and implemented modifications to improve overall performance of personnel.
Credentialing Specialist
Dr. John Martin, San Antonio Skin & Cancer Clinic
01.2017 - 08.2018
- Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
- Demonstrated excellent problem-solving skills when confronted with complex issues or discrepancies during the credentialing process.
- Enhanced credentialing processes by streamlining documentation and verification procedures.
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
- Obtained NPI numbers for providers and facilities and updated existing profiles.
- Improved turnaround time for credentialing applications by implementing an efficient online system.
- Updated and maintained accurate records in credentialing databases, ensuring timely renewals and verifications.
- Ensured compliance with industry standards by regularly updating policies and procedures related to credentialing.
Business Office Specialist
San Antonio Skin & Cancer Clinic
09.2002 - 08.2018
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Collected payments and applied to patient accounts.
- Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
- Efficiently processed refunds or adjustments for patients when necessary, ensuring accuracy and compliance with company policies.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.
- Developed customized reports for management review, highlighting trends in key performance metrics such as claim denial rates and days outstanding for accounts receivable balances.
- Maintained strong working relationships with healthcare providers, fostering clear communication regarding billing-related matters.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Posted and adjusted payments from insurance companies.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Assisted patients in understanding insurance benefits, leading to a positive experience during their visit.
- Coordinated with other departments to address any discrepancies or concerns related to charge capture or data entry accuracy.
Medical Receptionist
San Antonio Skin & Cancer Clinic
04.2002 - 09.2002
- Greeted and interacted with patients to provide information, answer questions and assist with appointment scheduling.
- Checked patient insurance, demographic, and health history to keep information current.
- Helped patients complete necessary medical forms and documentation.
- Maintained strict confidentiality of patient information, adhering to HIPAA regulations and medical office policies.
- Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Managed multi-line phone system and pleasantly greeted patients.
- Supported office staff and operational requirements with administrative tasks.
- Facilitated effective communication between patients, medical staff, and insurance companies to ensure seamless coordination of care.
Education
High School Diploma -
Galena Park High School
Houston, TX07-1996
Skills
- Office Administration
- Deadline Management
- Electronic medical records (EMR)
- ICD-10 Proficiency / CPT Knowledge
- CMS-1500 Billing Forms
- Files and records management
- HIPAA Compliance
- Electronic Health Record Software
- Able to read and interpret EOB's
- Data analysis and Reporting
Languages
Spanish
Professional Working
Timeline
Rideshare Driver
Uber/Lyft
01.2019 - 09.2024
Business Office Manager
San Antonio Skin & Cancer Clinic
08.2018 - 02.2021
Credentialing Specialist
Dr. John Martin, San Antonio Skin & Cancer Clinic
01.2017 - 08.2018
Business Office Specialist
San Antonio Skin & Cancer Clinic
09.2002 - 08.2018
Medical Receptionist
San Antonio Skin & Cancer Clinic
04.2002 - 09.2002
High School Diploma -
Galena Park High School
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