Jaclyn Gonzalez
Katy,TX
Summary
Hardworking and reliable person with strong ability in customer service and multi-tasking. Highly organized, proactive and punctual with team-oriented mentality and Eager to take my career to the next level.
I seek employment aimed at improving the quality of my skills and keeping a positive work environment. I look forward to meeting with you!
Overview
4
4
years of professional experience
Work History
Care Management Processor
Molina Healthcare
, TX
07.2022 - Current
- Communicated with patients with compassion while keeping medical information private.
- Adhered to HIPAA requirements to safeguard patient confidentiality.
- Collaborated with multi-disciplinary staff to improve overall patient care and response times.
- Confirm the authorizations are in place for the correct services the member has.
- Working with case management to ensure member has everything they need to be satisfied.
Insurance Verification Specialist
The Rose Diagnostic Center
Houston, TX
02.2021 - 07.2022
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Examined claims, records and procedures to grant approval of coverage.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
- Performed verification of Medicare coverage.
- Identified important patient and demographic information.
Insurance Verification Specialist(LEAD)
Lake Charles Memorial Health System
Lake Charles, LA
10.2019 - 01.2021
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
- Determined estimated self-pay portion by calculating charges, co-insurance and deductibles.
- Entered data in EMR database to record payer, authorization requirements and coverage limitations.
- Contacted patients to arrange payment arrangements for deductible and out-of-pocket liability.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
- Handled billing related activities focused on medical specialties.
Education
Some College (No Degree) - Medical
Delta Tech
Lake Charles, LASkills
- Insurance plan verification
- Skilled in Excel and Microsoft Word
- Electronic authorization processing
- Secure data practices
- Medical terminology
- Insurance terminology
- Medicaid knowledge
- Follow up with Insurance Claims
- Appeals
- Knowledge with Medical EOB's
- Working collaboratively
- Basic Math
Timeline
Care Management Processor
Molina Healthcare
07.2022 - Current
Insurance Verification Specialist
The Rose Diagnostic Center
02.2021 - 07.2022
Insurance Verification Specialist(LEAD)
Lake Charles Memorial Health System
10.2019 - 01.2021
Some College (No Degree) - Medical
Delta Tech