Summary
Overview
Work History
Education
Skills
Timeline
Generic

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

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

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Irasema Martinez