Francheska Rubio
Kissimmee,FL
Summary
Detail-oriented claims and billing professional with over five years of experience supporting adjusters, vendors, and patients through intricate workflows. Expertise in analyzing documentation, resolving discrepancies, and ensuring accurate, compliant billing while managing high-volume caseloads and meeting service expectations. Committed to delivering empathetic, client-focused support that aligns with Sedgwick's values of empathy, accountability, collaboration, growth, and inclusion. Eager to leverage a solid foundation in claims coordination and vendor communication to transition into Workers’ Compensation claims adjudication.
Overview
13
13
years of professional experience
1
1
Certification
Work History
ACCOUNTS PAYABLE ASSOCIATE
Careworks Managed Care
Greater Orlando, FL
01.2025 - Current
- Audits incoming invoices for accuracy and tax compliance, reducing payment errors and ensuring approval hierarchy adherence.
- Serves as primary vendor contact to resolve complex billing discrepancies and improve vendor satisfaction.
- Partners with internal departments to streamline approval workflows and accelerate payment cycle timelines.
- Analyzed and processed claims using structured action plans, improving issue-resolution turnaround by 30%.
PATIENT CARE COORDINATOR
Careworks Managed Care
Greater Orlando, FL
07.2022 - 01.2025
- Coordinated referral communications with partners and case managers to improve claimant response consistency and case flow.
- Verified patient demographics and updated referral status to ensure timely service delivery and accurate records.
- Managed quotes and approvals, securing medical necessity confirmation and correct billing authorization with a 98% accuracy rate.
- Reviewed and completed billing details to transition cases into daily billing workflows with measurable accuracy.
DMF CARE COORDINATOR
Orchid Medical
Greater Orlando, FL
08.2020 - 01.2022
- Confirmed patient referrals and verified demographics to improve scheduling accuracy and reduce appointment errors.
- Coordinated with adjusters and vendors to accelerate referral progress and decrease status uncertainty.
- Secured written approvals and documented medical necessity to ensure compliance and accurate claims processing.
- Validated billing details and integrated cases into daily billing workflows to maintain billing accuracy and timely revenue capture.
ATTRACTION ATTENDANT
Universal Orlando Resort
Greater Orlando, FL
07.2013 - 12.2020
- Improved ride uptime by enforcing safety and efficiency standards and resolving operational issues promptly.
- Resolved guest complaints professionally, improving guest satisfaction scores and reducing escalations by 20%.
- Reduced onboarding time by training new staff on procedures and control systems and improving team accuracy.
Education
MASTER OF HUMAN SERVICES - Human Services
University of Arizona Global Campus
Remote07-2024
Bachelor of Science - Integrative General Studies
University of Central Florida
Greater Orlando, FL05-2020
Skills
- Claims and billing assessment
- Workers’ Compensation Coordination
- Vendor & Adjuster Communication
- Documentation & Compliance
- Negotiation skills
- Multi-system data management
- Clear and concise communication
- Workflow optimization
- Conflict Resolution
- Analytical reasoning
- Data interpretation
License
- Florida 6-20 All-Lines Adjuster License | License #G341403 | Status: Active
Certification
- 0620 - ADJUSTER - ALL LINES
- 05/14/2026
- FLORIDA DEPARTMENT OF FINANCIAL SERVICES
Languages
English - Native
Spanish - Native
Timeline
ACCOUNTS PAYABLE ASSOCIATE
Careworks Managed Care
01.2025 - Current
PATIENT CARE COORDINATOR
Careworks Managed Care
07.2022 - 01.2025
DMF CARE COORDINATOR
Orchid Medical
08.2020 - 01.2022
ATTRACTION ATTENDANT
Universal Orlando Resort
07.2013 - 12.2020
MASTER OF HUMAN SERVICES - Human Services
University of Arizona Global Campus
Bachelor of Science - Integrative General Studies
University of Central Florida