Gracie Torres
Bakersfield,CA
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience.
Overview
22
22
years of professional experience
Work History
Insurance Service Specialist
Embark behavioral health
Bakersfield, CA
02.2023 - Current
- Conducted detailed reviews of existing policies to ensure accuracy of information on file.
- Navigated computer system to look up customer information and update policies.
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Examined claims, records and procedures to grant approval of coverage.
- Collaborated with fellow team members to manage large volume of claims.
- Initiated collection efforts on unpaid accounts by contacting insurance companies or patients directly via phone or mail.
- Provided customer service support to patients who had questions about their bills or payments due.
- Generated monthly invoices for patients based on services provided according to established fee schedules.
- Ensured HIPAA compliance by maintaining confidentiality of all patient information.
- Reviewed patient records for accuracy and completeness of information in medical billing system.
- Verified the accuracy of claim data prior to submission to insurance carriers.
- Analyzed rejected claims and corrected errors as necessary before resubmitting them for payment.
- Posted charges, payments and adjustments.
- Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
- Submitted refund requests for claims paid in error.
- Applied HIPAA privacy and security regulations while handling patient information.
Patient Registration Representative
Dignity Health
Bakersfield
01.2023 - 02.2023
- Greeted patients and answered questions regarding registration process.
- Collected patient demographic information, verified insurance coverage, and updated records as necessary.
- Processed payments for services rendered in a timely manner.
- Assisted with scheduling appointments, verifying benefits and authorizations for procedures.
- Responded to inquiries from patients, families, physicians, and other healthcare personnel.
- Performed quality assurance checks on all registrations to ensure accuracy of data entry.
- Provided support to the clinical staff with registration issues or concerns.
- Maintained confidentiality of patient information in accordance with HIPAA regulations.
- Verified insurance eligibility through online portals or by phone calls.
- Answered general questions about hospital policies and services provided.
- Assisted patients with completion of forms needed for admission process.
- Updated patient information in database regularly to ensure accuracy of records.
- Provided assistance to nursing staff during peak times at front desk area.
- Educated patients on their rights as well as hospital policies related to care delivery.
- Greeted patients, determined purpose of visit and directed to appropriate staff.
- Communicated with patients with compassion while keeping medical information private.
Medical Billing Clerk
PRIORITY URGENT CARE
Bakersfield, United States
10.2021 - 01.2023
- Applied HIPAA privacy and security regulations while handling patient information
- Completed and submitted appeals for denied claims
- Filed and submitted insurance claims
- Reviewed received payments for accuracy and applied to intended patient accounts
- Documented and filed patient data and medical records
- Reviewed medical records to meet insurance company requirements
- Assessed medical codes on patient records for accuracy
- Reviewed claims for coding accuracy
- Contacted insurance providers to verify insurance information and obtain billing authorization
- Reviewed account information to confirm patient and insurance information is accurate and complete.
Medical Records Clerk
CENTRAL VALLEY OCCUPATIONAL
Bakersfield, United States
05.2021 - 07.2021
- Scanned incoming documentation
- Kept department clean, organized and professional
- Purged outdated files
- Pulled patient charts for upcoming appointments
- Obtained information by contacting appropriate personnel or patients
- Organized patient charts, gathering medical histories, lab results and consents
- Scanned and validated medical records for upload
- Retrieved medical charts for healthcare staff for filing in medical records.
Receptionist
G STREET DENTAL
Bakersfield, United States
01.2017 - 07.2019
- Scheduled and confirmed appointments
- Answered and directed incoming calls using multi-line telephone system
- Sorted incoming mail and directed to correct personnel each day
- Updated and recorded customer or client information to maintain accounts
- Answered phone calls, provided information and connected callers to appropriate personnel
- Welcomed patrons to front desk and engaged in friendly conversations while conducting check-in process
- Answered office phone and emails to schedule appointments, answer questions and document information.
Receptionist
Kern Valley Dental
Bakersfield, United States
02.2002 - 08.2006
- Scheduled and confirmed appointments
- Answered and directed incoming calls using multi-line telephone system
- Answered phone calls, provided information and connected callers to appropriate personnel
- Handled payment processing and provided customers with receipts and proper bills and change
- Greeted incoming patients and verified paperwork to manage smooth intake processes
- Greeted visitors and verified reasons for visit and appointment information.
Education
MEDICAL BILLING AND CODING CERTIFICATE - MEDICAL BILLING
UEI COLLEGE
07.2021
High School Diploma -
VISTA P HIGH SCHOOL
05.1993
Skills
- Clerical Support
- Medical Transcription
- Information Confidentiality
- HIPAA Compliance Certification
- Multitasking and Organization
- Verbal and Written Communication
- Medical Terminology
- Chart Auditing
- Billing and Collection Procedures
- Claims Processing
- Account Posting
- Itemized Statement Preparation
- Billing Data Verification
- Patient Billing
References
References available upon request.
Timeline
Insurance Service Specialist
Embark behavioral health
02.2023 - Current
Patient Registration Representative
Dignity Health
01.2023 - 02.2023
Medical Billing Clerk
PRIORITY URGENT CARE
10.2021 - 01.2023
Medical Records Clerk
CENTRAL VALLEY OCCUPATIONAL
05.2021 - 07.2021
Receptionist
G STREET DENTAL
01.2017 - 07.2019
Receptionist
Kern Valley Dental
02.2002 - 08.2006
MEDICAL BILLING AND CODING CERTIFICATE - MEDICAL BILLING
UEI COLLEGE
High School Diploma -
VISTA P HIGH SCHOOL
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