Summary
Overview
Work History
Education
Skills
Timeline
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Hortensia Cortez

Surprise,AZ

Summary

Dedicated administrative professional with successful experience in fast-paced office settings. Hardworking team player with expertise in completing various clerical tasks and offering staff support. Responsible, punctual and productive professional when working with little to no supervision. Dynamic referral specialist with experience in scheduling and coordinating referrals. Proven track record of efficiently and accurately completing paperwork. Offers strong time management, organizational and multitasking abilities.

Overview

8
8
years of professional experience

Work History

Referral Specialist

Centene
Tempe, AZ
02.2021 - Current
  • Processed referral requests from patients, doctors and other health care professionals.
  • Weighed patient need, provider availability, and insurance coverage to determine optimal scheduling.
  • Developed and maintained strong working relationship with referral sources to streamline processing.
  • Coordinated with medical staff and patients to find cost-effective options for services.
  • Monitored referrals to foster timely completion and followed up with physicians to facilitate.

Patient Service Representative

TriWest Healthcare Alliance
Phoenix, AZ
10.2018 - 06.2022
  • Greeted and assisted patients with check-in procedures.
  • Helped address client complaints through timely corrective actions and appropriate referrals.
  • Resolved customer complaints using established follow-up procedures.
  • Trained new staff on filing, phone etiquette and other office duties.
  • Built and maintained positive working relationships with patients and staff.

Patient Service Representative

Banner Health
Phoenix, AZ
06.2020 - 01.2022
  • Investigated insurance claims denials and appeals.
  • Conducted risk evaluations on claims settlement proposals to encourage sound decision-making regarding settlement offers.
  • Communicated verification and authorization status updates with claims department to facilitate decision-making for patient admissions and insurance coverage.
  • Processed and recorded new policies and claims.
  • Followed up with customers on unresolved issues.
  • Provided advice to customers regarding claims, rights and insurance processes to prevent disputes.

Office Manager/Medical Billing and Collections Specialist

Fletcher Heights Chiropractic
Peoria, AZ
06.2015 - 10.2018
  • Kept vendor files accurate and up-to-date to expedite payment processing.
  • Entered invoices requiring payment and disbursed amounts via check, electronic transfer or bank draft.
  • Handled account payments and provided information regarding outstanding balances.
  • Utilized various software programs to process customer payments.
  • Responded to customer concerns and questions on daily basis.
  • Corrected, completed and processed claims for multiple payer codes.

Education

Diploma - Diploma in Medical Billing And Coding

Brookline College - Phoenix
Phoenix, AZ
03.2014

Diploma - Diploma in Medical Assistant

Long Technical College - East Valley
Phoenix, AZ
10.2004

High School Diploma -

Dysart High School
El Mirage, AZ
05.1991

Skills

  • Bilingual - Spanish
  • Project Requirements
  • Information Assistance
  • Clinic Administration
  • Patient Referral
  • OSHA Regulations
  • Insurance Verification
  • Patient Health Information Access
  • Pre-authorizations
  • Appointment Scheduling
  • Multi-line telephone operation
  • Insurance coding (ICD-9 and CPT)
  • Medical terminology
  • Teamwork and Collaboration

Timeline

Referral Specialist

Centene
02.2021 - Current

Patient Service Representative

Banner Health
06.2020 - 01.2022

Patient Service Representative

TriWest Healthcare Alliance
10.2018 - 06.2022

Office Manager/Medical Billing and Collections Specialist

Fletcher Heights Chiropractic
06.2015 - 10.2018

Diploma - Diploma in Medical Billing And Coding

Brookline College - Phoenix

Diploma - Diploma in Medical Assistant

Long Technical College - East Valley

High School Diploma -

Dysart High School

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Hortensia Cortez