Irasema Martinez
Deltona,FL
Summary
A highly trained professional adept in verifying insurance benefits and creating accurate patient documentation. Proficient in managing various office tasks effortlessly.
Overview
14
14
years of professional experience
1
1
year of post-secondary education
1
1
Language
Work History
Sr. Submission Coordinator
Impaxx
Daytona Beach , FL
4 2018 - 5 2024
- Coordinated 200 submission referrals over month for company services on national basis.
- Provided all parties with information and documentation needed to perform requested service promptly.
- Communicated with Medicare/CMS, performed independent research, and interpreted CMS memos to determine best option to comply with MSP statutes
- Independently assesses whether case meets CMS review thresholds and determines appropriate course of action to prevent CMS from banning our company from using its Online Submission Portal.
- Performed Data Entry into our company's proprietary application of all submission information into WCMSA portal
- Received, screened, and routed incoming telephone calls
- Supported team’s cohesiveness through ongoing diplomatic effective written and verbal communication
- Proactively completed additional assignments as directed by Team Leader or Management.
- Participated in workshops and in-service meetings to enhance personal growth and professional development.
- Enhanced customer satisfaction by responding promptly to inquiries and addressing concerns professionally.
- Tracked records, filed documents and maintained communication between clients to manage office activities.
- Enhanced operational workflows by maintaining well-organized documentation systems and updating records accurately as needed.
- Set priorities and problem-solved workflow issues to maintain rapport with customers and managers.
- Used job-related software to draft and finalize written correspondence and documentation.
Claims Assistant
Sedgwick Inc.
Lake Mary, FL
08.2004 - 04.2018
- Made arrangements for injured worker's appointments, transportation, and diagnostic referrals
- Additionally, prepared and delivered different types of correspondence to attorneys, injured workers, and physicians involved
- As interpreter, facilitating communication between Claims Examiners and Spanish-speaking claimants through correspondence or phone calls
- Moreover, effectively translated English correspondence into Spanish
- Contributed to phone coverage within reception area and handled payments for vendors and legal invoices
- Prepared workers' compensation cases for Medicare Set-Aside referrals.
- Reduced claim resolution times with thorough investigation and prompt communication with involved parties.
- Ensured compliance with company policies and industry regulations through meticulous documentation of claim files.
- Provided exceptional customer service through clear communication, empathy, and proactive problem-solving during difficult situations.
Education
4-40 License - RCSR Registered Customer Service Representative (In progress) -
American Insurance College
South Daytona, FL 05.2024 - 12.2024
Associate of Science - Business Administration And Management
Orlando College DBA Everest University
Orlando, FL 01.1995 - 06.1995
Skills
Data Entry
Customer Service
Relationship Building
Point of Contact
Medical Terminology
Teamwork and Collaboration
Adaptability and Flexibility
Problem-solving abilities
Time management abilities
Microsoft Office
Project Coordination
Timeline
4-40 License - RCSR Registered Customer Service Representative (In progress) -
American Insurance College
05.2024 - 12.2024
Claims Assistant
Sedgwick Inc.
08.2004 - 04.2018
Associate of Science - Business Administration And Management
Orlando College DBA Everest University
01.1995 - 06.1995
Sr. Submission Coordinator
Impaxx
4 2018 - 5 2024