Summary
Overview
Work History
Education
Skills
Work Availability
Quote
Timeline
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GRACE URIBES

GRACE URIBES

San Bernardino,CA.

Summary

Dependable and service-oriented professional with expertise in processing and coding claims, ensuring all required criteria are met before eligible payments are issued to claimants. Proven track record of meeting targets, with strong analytical skills and attention to detail. Well-versed in working and collaborating in a fully remote professional environment.

Hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience.

Overview

33
33
years of professional experience

Work History

Case Manager

TEKsystems
05.2023 - 09.2023
  • Remote
  • Ensures program applicants are continuously updated regarding the status of their program application
  • Frequent, diligent, and professional communication required
  • Obtains a working knowledge of applicant needs and program eligibility criteria
  • Understands program requirements and other key objectives
  • Understands program processes from start to finish and communicates those processes clearly to applicants
  • Gathers applicant documentation and uploads to program system of record
  • Records all communications in the program system of record
  • Strong customer service skills and knowledge of customer service best practices
  • Ability to maintain confidentiality of program information
  • Ability to use analytical skills to interpret and evaluate information
  • Received EDD UI during gap in employment.

Claims Specialist

08.2022 - 03.2023
  • Remote
  • Evaluate unemployment insurance claims data for potential eligibility issues
  • Make outbound calls as needed to interview claimants for information verification to resolve any noted claim issues or discrepancies
  • Review unemployment insurance claims for weekly benefit amounts and payments
  • Process claims with confirmed eligibility issues for potential adjudication and determination by the
  • California Employment Development Department
  • Document claimant interactions, along with actions taken to supplement case notes
  • Collaborate with subject matter experts to address unique issues
  • Analyze claim information to determine the cause of outstanding
  • Issues and determine next steps to resolve these issues.

Deferred ER Protest Agent

Maximus
, Remote
03.2014 - 05.2022

Call Center Agent

Agent Maximus, Nd, Century Technologies
, Remote
05.2013 - 01.2022

Sales Advisor

Club Demonstration Services
01.2021 - 12.2021
  • Setup and take down demo station as required
  • Prepped and cooked food according to specifications
  • Used proper food handling and temperatures
  • Conducted demonstrations that introduced customers to
  • New products
  • Operated microwave, hot kettles, and electric skillets.

Homemaker

10.1990 - 12.2020
  • I took care of the home and family
  • Budgeted finances and expenses
  • Cooked and cleaned
  • Washed, dried, and put dishes away
  • Washed, dried, put laundry away
  • Used vacuum cleaner and

Registrar of Voters
02.2020 - 02.2020
  • Took inbound/outbound calls to potential voters
  • Transferred calls to various departments
  • Took down messages for department heads when unavailable
  • Operated multiline phone system.

MOA Extern

, M.D.
08.2018 - 10.2018
  • Assisted with the front office duties with posting Prime Care and HMO payments into patient accounts
  • Into the Electronic Healthcare Record software
  • Called patients regarding his/her referral status
  • Returned telephone calls for those that left messages
  • Scanned and filed patients’ referrals into the Electronic Healthcare Record
  • Logged information into each account as required
  • Checked patients Inland Empire Health Plan and Prime Care eligibility
  • Requested clinical notes from other specialties and procedure results.

Education

Medical Office Admin -

10.2018

School, Diploma -

PAL Charter Academy
06.2004

Medical Assistant -

Concorde Career College
06.2003

Diploma -

Concorde Career College

Skills

  • Customer Service
  • Research
  • Analysis
  • Schedule Management
  • Complaint Resolution
  • Microsoft Office
  • Microsoft Teams
  • Multiple systems logins utilizing different multi-factor authentication applications
  • 3270 HHSDC Session/DOS-based systems
  • Zoom Online
  • Peoplesoft
  • Administrative Skills (Medical Office Admin)
  • ICD-10/PCS
  • CPT
  • HCPCS
  • EHR
  • Claims
  • CMS-1500(02-12)
  • COB
  • Eligibility of Benefits
  • ABN
  • UBO4/837P
  • Denials
  • Authorization
  • Rx refills
  • Referrals
  • 48 WPM
  • Billing Skills (Medical Office Admin)
  • Medicare
  • 4
  • HMO/PPO
  • Tricare
  • IEHP
  • Blue Cross
  • Blue Shield
  • Workers Comp
  • Disability
  • Clinical
  • Vitals
  • Venipuncture
  • Injections
  • 12-Lead EKG
  • Hematocrit
  • Capillaries
  • HCG Test
  • Blood Typing
  • Cultures
  • Surgical Tray
  • Pap Tray
  • Auto-clave
  • Case Management Tracking

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote

There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins

Timeline

Case Manager

TEKsystems
05.2023 - 09.2023

Claims Specialist

08.2022 - 03.2023

Sales Advisor

Club Demonstration Services
01.2021 - 12.2021

Registrar of Voters
02.2020 - 02.2020

MOA Extern

08.2018 - 10.2018

Deferred ER Protest Agent

Maximus
03.2014 - 05.2022

Call Center Agent

Agent Maximus, Nd, Century Technologies
05.2013 - 01.2022

Homemaker

10.1990 - 12.2020

Medical Office Admin -

School, Diploma -

PAL Charter Academy

Medical Assistant -

Concorde Career College

Diploma -

Concorde Career College

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