Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Esmeralda Chavez

Moreno Valley,CA

Summary

Dynamic Patient Account Representative with Prime Healthcare Management, skilled in claims processing and insurance verification. Proven track record of resolving discrepancies and enhancing collections, while maintaining confidentiality and compliance. Recognized for effective communication and a client-focused approach, driving improvements in billing accuracy and customer satisfaction. Reliable team player dedicated to achieving results.

Overview

1825
1825
years of professional experience

Work History

Patient Account Representative

Prime Healthcare Management
Ontario
02.2023 - Current
  • Resolved any issues arising from incorrect or incomplete documentation relating to a particular claim.
  • Maintained accurate records of collections, adjustments and denials in the system.
  • Investigated incorrect billings and processed refunds as necessary.
  • Performed additional duties as assigned by management team.
  • Reviewed medical records to ensure accuracy of billing information and patient data.
  • Generated periodic reports summarizing account balances and collection activities.
  • Verified insurance coverage and identified third-party payers for billing purposes.
  • Provided support to other departments within the organization as needed.
  • Worked with team members to identify and develop process improvements.
  • Monitored past due accounts and pursued collections on outstanding invoices.
  • Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
  • Maintained confidentiality of patient information in accordance with HIPAA regulations.
  • Provided timely follow up with payers regarding payment status of claims.
  • Collaborated with internal staff members such as Billing Specialists, Medical Coders to resolve any discrepancies in patients' insurance information.
  • Resolved insurance-related issues and discrepancies to prevent claim denials.

Store Clerk

Mothers Nutritional center
Moreno Valley, CA
11.2021 - 02.2022
  • Interacted with over 50 customers daily.
  • Monitored work areas for cleanliness and functionality and removed obstacles for safety.
  • Inspected deliveries, replenished shelves and stored excess products to keep on top of stock management tasks.
  • Stored items in orderly and accessible manner in warehouse tool rooms, supply rooms, or other areas.
  • Greeted customers promptly and responded to questions.
  • Maintained work area and kept cash drawer organized.
  • Scanned items and checked pricing on cash register for accuracy.
  • Boosted customer satisfaction levels by going extra mile to personalize service for each customer.
  • Offered customers carry-out service at completion of transaction.
  • Adhered to social distancing protocols and wore mask or face shield.

Assistant Store Manager

American Frieght
Corona, CA
10.2019 - 03.2020
  • Assisted in continuous development of effective store associates to achieve desired sales and results.
  • Completed frequent walk-throughs and directed team members to correct issues impacting store appearance or professionalism.
  • Oversaw aspects of maintenance, inventory and daily activity management.
  • Delegated assignments based on team strengths to optimize floor coverage and service levels.
  • Provided mentorship for employees to generate sales, promote effective upselling and cross-sell to improve retail productivity.
  • Led teams in planning, implementation and execution of merchandising and operating initiatives to streamline business effectiveness.
  • Interviewed and vetted job applicants to make effective hiring decisions and fill vacancies with strong team members.
  • Handled scheduling for store shifts to achieve adequate staffing.
  • Checked monthly sales and performance reports to support operational planning and strategic decision-making.
  • Maintained inventory by checking merchandise to determine levels.
  • Handled complaints from customers by empathetically listening, recording details and offering solutions.
  • Supervised cashiers in processing credit, debit and cash payments to streamline sales.
  • Answered customer questions and addressed problems and complaints in person and via phone.
  • Oversaw daily operations of store, including inventory and supply restocking, cash-handling and assisting customers.
  • Trained staff on daily duties and supervised and provided feedback, resulting in improved performance and customer satisfaction.
  • Coordinated merchandising by planning floor layouts and displays, guiding resets and directing sales signage placement.

Assistant Sales Manager

Sears Outlet Store
Corona, PA
07.2017 - 10.2019
  • Opened and closed store, set up registers and secured cash.
  • Promoted exceptional levels of customer service by asking open-ended questions and assisting clients on sales floor.
  • Helped sales professionals finalize customer sales and handled escalated concerns.
  • Taught new associates sales tactics and performance improvement techniques.
  • Utilized company selling model to engage and connect customers with brand.
  • Evaluated store performance and recommended action plans to increase productivity.
  • Collaborated closely with management team to recruit top-level sales talent to fill positions within department.

Sales Lead

Sears Outlet
Santa Ana, CA
06.2016 - 07.2017
  • Engaged shoppers, providing assistance and information on merchandise and product features.
  • Monitored sales floor to identify customers in need of assistance and merchandise requiring replenishment.
  • Maintained attractive merchandise displays to maximize purchases.
  • Promoted accessories and cross-sold additional products and services through use of active persuasion.
  • Made outbound sales calls to contact prospective leads, using effective communication skills.
  • Processed payments and returned receipts, cash, coin and cards to customers.
  • Promoted positive culture of teamwork and inclusion, increasing employee morale.
  • Built repeat customer base by driving excellent loyalty program and data capture.
  • Fostered great experience by engaging with guests, utilizing acquired skills and training.
  • Familiarized self with new products and services to engage with customers about features and benefits.

Sales Key Holder

RadioShack
Santa Ana, CA
01.2013 - 01.2015
  • Performed store opening and closing tasks to comply with preset store operations guidelines.
  • Maintained updated brand and product knowledge to deliver optimum customer shopping experience.
  • Completed point of sale opening and closing functions to enable accurate transaction processing and accounting operations.
  • Stocked and merchandised products in compliance with Plan-o-Grams and company guidelines to facilitate organized, attractive store layout.
  • Adhered to company policies and procedures and recommended coworkers' compliance to establish uniform standard of conduct.
  • Operated cash register.
  • Maintained store and maintained appearance.
  • Signed for incoming shipments in manager's absence.
  • Set up visually appealing promotional displays.
  • Responded to safety and loss prevention incidents.
  • Monitored cash drawers in checkouts to verify adequate cash supply.
  • Monitored sales performance through analysis of sales reports and comparison shopping.
  • Developed good working relationships with store leadership and sales personnel.
  • Suggested additional items and merchandise to boost sales.

Sales Associate

Don Roberto Jewelers
Santa Ana, CA
10.201 - 04.2014
  • Collected payments and provided accurate change.
  • Completed daily recovery tasks to keep areas clean and neat for maximum productivity.
  • Helped customers find specific products, answered questions and offered product advice.
  • Arranged new merchandise with signage and appealing displays to encourage customer sales and move overstock items.
  • Reviewed files, recordings and other documents to obtain information to respond to requests.
  • Developed trusting relationships with customers by making personal connections.
  • Engaged customers in friendly, professional dialogue to determine needs.
  • Increased purchase amounts by cross-selling with similar products.
  • Assisted teammates with sales-processing tasks to meet daily sales goals.
  • Adhered to company initiatives and achieved established goals.
  • Obtained signatures for financial documents and internal and external invoices.

Education

High School Diploma -

Bolsa Grande High School
Garden Grove, CA
06.2012

Skills


  • Effective communication
  • Claims processing
  • Medical billing
  • Insurance verification
  • Cash handling accuracy
  • Client account management
  • Customer- and service-oriented
  • Outgoing personality
  • Documentation and recordkeeping
  • Listening skills
  • Reading comprehension
  • Business development
  • Excellent communication skills
  • Energetic self-starter
  • Reliable and punctual
  • Team player mentality
  • Written and oral communication skills
  • Medical Billing Understanding
  • Follow-up skills
  • Collections experience

Languages

English
Professional
Spanish
Professional

Timeline

Patient Account Representative

Prime Healthcare Management
02.2023 - Current

Store Clerk

Mothers Nutritional center
11.2021 - 02.2022

Assistant Store Manager

American Frieght
10.2019 - 03.2020

Assistant Sales Manager

Sears Outlet Store
07.2017 - 10.2019

Sales Lead

Sears Outlet
06.2016 - 07.2017

Sales Key Holder

RadioShack
01.2013 - 01.2015

High School Diploma -

Bolsa Grande High School

Sales Associate

Don Roberto Jewelers
10.201 - 04.2014

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