Jazma Perez
Desoto,TX
Summary
Dependable Customer Service Specialist recognized for consistency in productivity and attendance while exhibiting a positive attitude in light of challenging situations. Exhibits exemplary work ethic and willingness to learn new processes and techniques which enhance business and team efforts. Authorized to work in the US for any employer Versatile professional serves as first point of contact for patients by verifying insurance, handling paperwork and preparing records. Patient-oriented and helpful candidate familiar with MS Office and EHR systems coupled with thorough knowledge of medical terminology. Committed to providing personalized service and quality patient care.
Overview
15
15
years of professional experience
Work History
Pre-Notification Specialist
OneShare Health, LLC
Irving, TX
10.2022 - Current
- Enhanced patient care by providing clinical support to healthcare professionals, ensuring efficient and effective treatment
- Assisted in the development of clinical protocols for improved patient outcomes and satisfaction
- Streamlined internal processes for better coordination between medical staff and patients, leading to increased quality of care
- Implemented innovative solutions to complex medical cases, resulting in successful treatment plans and positive patient experiences
- Increased customer satisfaction with timely follow-ups, ensuring all necessary documentation was collected and processed promptly
- Contributed to a reduction in client wait times by effectively managing appointment scheduling and resource allocation
- Improved patient care by conducting thorough pre-notification assessments for medical procedures and services
- Reduced denials and appeals by ensuring accurate documentation and timely submission of pre-notification requests
- Managed a high volume of concurrent cases, prioritizing tasks based on urgency while maintaining keen attention to detail throughout the pre-notification process
- Maintained up-to-date knowledge of insurance guidelines and regulations, ensuring compliance in all pre-notification activities.
Member Support Specialist
OneShare Health LLC
Irving, TX
04.2021 - 10.2022
- Complied with HIPAA guidelines and regulations for confidential patient data
- Assisted members with understanding personalized Program sharing and Eligibility
- Assured timely verification of member's program prior to patient procedures or appointments
- Trained new staff on current, program guideline verification procedures and navigating AS400, Salesforce and HCI
- Responded to members calls and emails to answer questions about program guidelines
- Educated member's on company systems, form completion, and access to services
- Exhibited high energy and professionalism when dealing with member's and staff
- Improved customer satisfaction by providing timely and accurate information on medical bill status and resolution
- Collaborated with cross-functional teams to expedite complex claims investigations and resolutions
- Conducted detailed assessments of claims documents, ensuring accuracy and completeness before submission for approval
- Trained new Member Support Specialists on company policies, procedures, and software systems, improving overall team productivity
- Followed up with members and providers on unresolved issues.
Senior Support Specialist
Multiplan
Irving, TX
05.2019 - 04.2021
- Obtained scanned records and uploaded into company databases
- Volunteered to assist with special office projects, successfully completing tasks prior to deadlines
- Translated written documentation and notes into emails and other types of correspondence
- Transferred written information into databases to maintain consistent, accurate client records and project details.
- Maintained detailed records of help desk tickets and other customer service requests.
Medical Customer Service Representative
Alegis Revenue Group, LLC
Dallas, TX
03.2015 - 05.2019
- Answered patient questions and fielded complaints to resolve issues
- Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations
- Enhanced communication between clients and providers through consistent follow-ups and progress updates
- Collaborated with multidisciplinary teams to address client needs and formulate tailored support strategies
- Facilitated successful transitions between levels of care by developing detailed discharge plans and coordinating resources
- Provided crisis intervention support for clients experiencing emergencies, using appropriate techniques to de-escalate situations safely.
Insurance Verification Representative
Prime Therapeutics
Irving, TX
12.2008 - 03.2015
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients
- Updated patient and insurance data and input changes into company computer system
- Checked documentation for appropriate coding, catching errors and making revisions
- Instructed clients on amounts covered under benefits plans in easy-to-understand terminology
- Examined claims, records and procedures to grant approval of coverage
- Performed verification of Medicare coverage
- Pulled patient files and forwarded to appropriate offices for processing
- Kept office spaces well-stocked with administrative and medical supplies.
Education
High School Diploma -
W. Carter High School
05.2008
Skills
- Active Listening
- New Hire Training
- Resolving Issues
- Call Control Skills
- Logging Call Information
- Calm and Professional Under Pressure
- Scheduled and confirmed patient appointments with patients and healthcare professionals
- Referred patients to appropriate professionals and services
- Checked daily doctor schedules and verified insurance
- Checked claims for errors, corrected issues and mailed out updated documents
- Met with patients and family members to discuss medical procedures, medications, treatments and continuing care plans
- HIPAA
- Medical Billing
- Salesforce
Timeline
Pre-Notification Specialist
OneShare Health, LLC
10.2022 - Current
Member Support Specialist
OneShare Health LLC
04.2021 - 10.2022
Senior Support Specialist
Multiplan
05.2019 - 04.2021
Medical Customer Service Representative
Alegis Revenue Group, LLC
03.2015 - 05.2019
Insurance Verification Representative
Prime Therapeutics
12.2008 - 03.2015
High School Diploma -
W. Carter High School
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