Janet Madriaga
Bristow,VA
Summary
Working towards getting a certification as a Certified Professional Coder (CPC) and Certified Medical Biller (CPB) with more than 15 years working in the medical field.
Professionally committed to delivering high-quality customer service, adept at identifying and resolving issues to enhance customer satisfaction. Known for effective collaboration with teams and achieving timely resolutions. Reliable and adaptable, proficient in conflict resolution and customer relationship management.
Proficient in Adobe Illustrator, Microsoft Office and basic computer skills. Finished some coursework in Interior Design and Graphic Design programs such as Architectural Drafting, Interior Space, 2D and 3D Design, Color Theory, Drawing and Adobe Illustrator. Strong telephone etiquette. Possess excellent typing speed and has the ability to operate office equipment. Ability to read, comprehend, and follow oral and written instruction.
Overview
21
21
years of professional experience
Work History
Medical Biller
Evergreen Health Care Management
10.2024 - Current
- Manage and process billing for Personal Care, Hospice, Adult Day Care, and Home Health services.
- Handle Medicaid and Medicare authorizations, especially through CCCP (Commonwealth Coordinated Care Plus), working directly with major insurers: Anthem, Aetna, Molina, Sentara, Humana, UHC, and VA Medicaid.
- Accurately use and maintain scheduling and billing tools.
- Process and monitor authorizations in the myEVV system.
- Communicate with insurance companies to resolve billing disputes, clarify authorizations, and address other payment-related issues.
- Collaborate with the customer service team and clinicians to ensure proper information flow.
- Manage financial records and reports, ensuring compliance with state and federal policies.
Customer Service Rep - Problem Resolution Team
QUEST DIAGNOSTICS LABORATORY
01.2004 - 12.2017
- Handles all customer inquiries received by telephone, fax or email regarding reporting of patient results, inquiries of tests and services, concerns of service failures and other duties needed to provide superior service
- Reports laboratory results to clients using established protocols
- Documents reporting or call history in the required format and maintained complete and accurate records
- Contacts the client to resolve routine matters related to patient testing and result reporting
- Reports client concerns using established protocols
- Provides education and guidance to clients about Quest Diagnostics lab processes
- Understands the importance of Quality Service and how it is measured
- Escalates issues as appropriate using established protocols
- Provides research and resolution on complex issues, including those that have been referred by CSR I and Assistants
- Coach or mentor less experienced staff
- Responsible for maximizing quality and efficiencies to meet department
- Lead by example in demonstrating 'gold standards' behaviors
- Performs other duties as required to meet the customer requirements
Education
Undergraduate - Some College Coursework (General Studies)
Northern Virginia Community College
Undergraduate - Graphic Design
Art Institute of Washington
Undergraduate - Pre-Dentistry
University of Baguio, Philippines
01.2003
References
Names/Phone numbers available upon request.
Timeline
Medical Biller
Evergreen Health Care Management
10.2024 - Current
Customer Service Rep - Problem Resolution Team
QUEST DIAGNOSTICS LABORATORY
01.2004 - 12.2017
Undergraduate - Graphic Design
Art Institute of Washington
Undergraduate - Some College Coursework (General Studies)
Northern Virginia Community College
Undergraduate - Pre-Dentistry
University of Baguio, Philippines