ISAMAR PEREZ
North Lauderdale,USA
Summary
Dedicated and highly skilled in billing, customer service, with experience in resolving complex customer inquiries. Strengths include strong communication skills, problem-solving abilities, and familiarity with payment software and database systems. I have made a significant impact in previous roles by enhancing customer satisfaction and streamlining payment processes. Solid team player with an upbeat, positive attitude, and motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic, and results-oriented.
Overview
12
12
years of professional experience
Work History
Billing Customer Service
SHARED SERVICES CENTER
07.2023 - Current
- Answer inbound call inquiries related to hospital claims and billing.
- Objectively process payments from hospital patients and guarantors using designated hospital payment systems.
- Analyze and communicate patient financial responsibilities attributed to their health plan benefits and accumulations.
- Update patient account data as needed with most up-to-date information when received by patients or other verified sources.
- Document all encounters and updates to insurance and prior auth statuses in patient accounts and internal, company systems accordingly.
- Assist the correspondence team by researching updated patient addresses for returned mail and entering any new data/information into patient accounts as well as Microsoft Excel spreadsheets.
- Inspect and maintain credit card scanner inspection log using Microsoft Excel spreadsheet daily both at the beginning and end of shift ensuring compliance with company standards.
- Submit requests for documents such as itemized bills and UB04 for patients and insurance companies as needed.
- Submit requests for coding and/or charge reviews as needed.
- Partner with correspondence team to research and update patient address records, improving mail delivery accuracy and communication and entering any new information obtained into Microsoft Excel spreadsheet as well.
- Taylor each Financial Assistance application with patient information and add to outbound mail folder as requested.
Benefits Coordinator
ASTON CARTER/IQVIA
12.2022 - 05.2023
- Place outgoing phone calls to designated Pharmacy Benefits Manager on patient’s behalf for verification of pharmacy benefits.
- Route calls to appropriate resource/departments.
- Assist inbound team with in-bound calls when warranted by business needs.
- Create new patient profiles and capture all necessary demographic information to enter into database accurately and in a timely manner.
- Document call information according to company standard operating procedures in patient accounts.
- Maintain a positive and professional demeanor.
- Utilize multiple company database programs for accessing and updating member records.
- Achieve individual performance goals for productivity and quality.
- Maintain confidentiality of patient and proprietary information [HIPAA standards].
- Facilitate cross-departmental communication to ensure accurate benefit verification enhancing overall patient experience.
Customer Care Representative
Elixir Rx Solutions
10.2019 - 06.2020
- Answer and respond to inbound calls and emails.
- Resolve pharmacy issues from members, providers and pharmacies.
- Respond to routine inquiries on multiple products from members, providers, pharmacies, and employer groups.
- Research required information using job aides and other available resources.
- Place outgoing phone calls when business ventures warrant.
- Route calls to appropriate resources and departments.
- Document all call information according to standard operating procedures and update patient data when necessary.
- Enter data accurately and timely.
- Maintain a positive and professional demeanor.
- Utilize multiple company database programs for accessing member information such as Pharmscreens, PAhub, Excel created Quick Check docs, etc.
- Achieve individual performance goals for productivity and quality.
- Maintain confidentiality of patient and proprietary information [HIPAA standards].
Insurance Verification Specialist
Stand-Up MRI
Boca Raton, FL
10.2018 - 09.2019
- Verify insurance status prior to submitting prior authorization requests.
- Initiate and follow up with prior authorization requests/process until determination complete and advise patients and/or providers of outcome.
- Go over schedule daily for new appointments [up to one month out] and ensure any needed prior authorizations were initiated/completed.
- Answer and triage incoming phone calls as well as take messages for necessary departments and/or personnel.
- Update patient files/accounts as needed with most up-to-date data.
- Ensure patient insurances are fully verified for the next day’s schedule.
- Document encounters and updates to insurance and prior auth statuses in patient accounts and internal company systems accordingly.
- Ensure scanning of necessary patient documents into patient accounts.
- Complete other duties as assigned.
Assistant Patient Care Manager
Village Care
New York, NY
09.2015 - 05.2017
- Maintain ongoing contact with patients by home visits, telephone contact and mail to monitor services and case status.
- Make reminder phone calls to clients for important appointments and provide outreach to patients who had been non-compliant with necessary treatment/appointments.
- Identify client-level barriers to appropriate screening, diagnostic and treatment services.
- Accompany members to appointments, social service meetings and court hearings, as warranted advocating for, educating and coaching patients toward self-management.
- Monitor patient entitlements, insurance and benefits to ensure they remain in place.
- Alert Care Manager when entitlements / benefits lapse as well as assist Care Manager with reinstatement of discontinued benefits/services.
- Collect client and patient data for tracking and updates as required by program.
- Maintain up-to-date daily client records through the various electronic record systems such as Allscripts, BHH and HHC used accordingly to establish procedure.
- Coordinate ongoing navigation and logistical support for appointment keeping, reminders, and arrangement of transportation.
- Provide appropriate referrals and ensure follow-up by monitoring the quality of service, advocating for patient needs, verifying and ensuring client participation.
- Provide critical feedback to other members of the health care team based on his/her observations in the field.
- Assist care team in preparing applications for housing, support services and entitlements.
- Participate in on-going health, treatment and social service training and all required meetings.
- Ensure scanning of necessary patient documents into patient accounts.
Health Home Administrative Coordinator
Essen Medical House Calls
Bronx, NY
11.2013 - 08.2015
- Answer and triage incoming phone calls as well as take messages for necessary departments and/or personnel.
- Complete and document outreach and engagement segments for potential Bronx Health Home members via the company’s various data systems.
- Follow protocol for assigned and bottom-up patient referrals.
- Verify insurance status prior to engagement, outreach or scheduling.
- Schedule home visits for BHH clinical coordinator for outreach and assessments.
- Conveniently route home visit schedules using google maps and created spreadsheets accordingly using Microsoft Excel.
- Scanned and uploaded BHH consent forms into Allscripts Care Director.
- Upon receiving Chronic Care Management consent forms from IMG/FMGs, scan and upload consent forms into EClinicalWorks.
- Assist with Spanish/English translations for case managers and care coordinators, both in office and out on the field.
- Complete required documentation.
- Perform data entry and other administrative tasks as needed.
Education
Respiratory Therapy - Degree not completed
Borough of Manhattan Community College
New York, NY05.2011
High School Regents Diploma -
DeWitt Clinton HS
Bronx, NY06.2008
Skills
- Detail-oriented
- Supervisory skills
- Excellent verbal and written communication skills
- Proficient in Microsoft Word and Excel
- Mac OS X
- Windows
- Exceptional organizational skills
- Knowledge of EClinical Works
- Knowledge of Allscripts
- Knowledge of Epaces
- Knowledge of remote phone systems
- Ability to multitask in a fast-paced environment
- Ability to meet deadlines
- HIPAA verification/law knowledge
- Insurance verification
- Payment processing
- Patient account management
- Data entry accuracy
- Time management
Languages
- English
- Spanish
Languages
English
Native/ Bilingual
Spanish
Native/ Bilingual
Timeline
Billing Customer Service
SHARED SERVICES CENTER
07.2023 - Current
Benefits Coordinator
ASTON CARTER/IQVIA
12.2022 - 05.2023
Customer Care Representative
Elixir Rx Solutions
10.2019 - 06.2020
Insurance Verification Specialist
Stand-Up MRI
10.2018 - 09.2019
Assistant Patient Care Manager
Village Care
09.2015 - 05.2017
Health Home Administrative Coordinator
Essen Medical House Calls
11.2013 - 08.2015
Respiratory Therapy - Degree not completed
Borough of Manhattan Community College
High School Regents Diploma -
DeWitt Clinton HS