Work Preference
Summary
Overview
Work History
Education
Skills
Timeline
Generic
Open To Work

Jena Gonzalez

San Jose

Work Preference

Job Search Status

Open to work
Desired start date: Open to discussion

Desired Job Title

Patient Service RepresentativePatient Account Representative

Work Type

Full Time

Location Preference

On-SiteRemote
Location: San Jose, USSunnyvale, CAMountain View, CALos Gatos, CA
Open to relocation: No

Salary Range

$45/hr - $1000/hr

Important To Me

Paid time offPaid sick leaveHealthcare benefits

Summary

Dynamic Patient Service Representative with a proven track record with Lewis L. Haut, M.D. Inc., excelling in insurance verification and customer service. Achieved significant reductions in claim denials through meticulous attention to detail and proactive problem-solving. Skilled in medical billing and adept at multitasking, ensuring compliance and enhancing patient satisfaction.

Overview

20
20
years of professional experience

Work History

Patient Service Representative

Care First Pediatrics
08.2013 - Current
  • Managed patient scheduling to optimize appointment flow and reduce wait times.
  • Coordinated insurance verification to ensure accurate billing and coverage information.
  • Maintained electronic health records with attention to detail for compliance and accuracy.
  • Trained new staff on office procedures and systems to enhance team performance.
  • Verified insurance eligibility and coverage for patients.
  • Maintained compliance with industry regulations and standards by staying current on relevant laws, policies, and best practices for handling insurance claims.
  • Upheld a high level of accuracy by consistently double-checking figures, data entries, calculations, before finalizing any settlement documents or payments.
  • Minimized financial losses by identifying and addressing fraudulent claims through rigorous investigation and analysis.
  • Expedited claim resolutions by adopting proactive approach to gathering necessary documentation and evidence.
  • Facilitated inter-departmental collaboration to address and resolve claim disputes, leading to smoother operational flow.
  • Processed and recorded new policies and claims.
  • Investigated discrepancies in claims, collaborating with clients and stakeholders for accurate resolution.
  • Evaluated documentation and evidence to determine claim validity, ensuring timely payouts.
  • Streamlined claims review process, reducing turnaround time while maintaining quality standards.
  • Evaluated and settled complex insurance claims in strict timeframes.
  • Improved claims processing efficiency by meticulously reviewing and validating each claim for accuracy and completeness.
  • Maintained up-to-date knowledge of regulatory changes, ensuring compliance in all claim handling procedures.
  • Generated, posted and attached information to claim files.
  • Posted payments to accounts and maintained records.
  • Prepared insurance claim forms or related documents and reviewed for completeness.
  • Calculated adjustments, premiums and refunds.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.

Patient Account Representative

Lewis L. Haut, M.D., Inc
07.2013 - Current
  • Managed patient billing inquiries to ensure accurate account resolution.
  • Collaborated with insurance providers to verify coverage and benefits efficiently.
  • Processed patient payments and maintained up-to-date financial records.
  • Assisted in resolving discrepancies in patient accounts through detailed investigations.
  • Posted payments and processed refunds.
  • Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
  • Conducted regular audits of patient accounts, identifying discrepancies and rectifying errors as needed.
  • Electronically submitted bills according to compliance guidelines.
  • Ensured compliance with healthcare regulations while processing claims and managing patient accounts.
  • Collaborated with the medical staff to ensure proper documentation and coding for accurate billing.
  • Maintained accurate records of all transactions, ensuring timely payments from patients and insurance providers.
  • Prepared reports detailing billing actions, flags, and other key information.
  • Achieved a significant reduction in aged accounts receivable through diligent follow-up efforts with both patients and insurers.
  • Utilized computer programs to create invoices, letters, and other documents.
  • Reduced outstanding balances by implementing effective collection strategies tailored to individual patients'' needs.
  • Monitored flags and resolved urgent items with accuracy and efficiency.
  • Reconciled statements with patient records.
  • Generated and distributed monthly customer statements.
  • Contacted customers to discuss past-due accounts and negotiated payment plans.

Medical Billing Specialist

Bernard Recht, M.D.
07.2009 - 06.2013
  • Processed and submitted medical claims to insurance companies for reimbursement.
  • Reviewed patient bills for accuracy and completeness prior to submission.
  • Resolved discrepancies by communicating with healthcare providers and insurance representatives.
  • Implemented process improvements that enhanced billing efficiency and reduced claim denials.

Medical Billing Specialist

Pacific Therx
07.2005 - 07.2009
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Posted payments and collections on regular basis.
  • Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.

Education

High School Diploma -

South Tahoe High
So. Lake Tahoe, CA

Skills

  • Customer service
  • HIPAA compliance
  • Insurance verification
  • Appointment scheduling
  • Payment collection
  • Medical terminology
  • Multitasking and organization
  • Payment processing
  • Referral coordination
  • Medicaid
  • Medical billing
  • Insurance billing

Timeline

Patient Service Representative

Care First Pediatrics
08.2013 - Current

Patient Account Representative

Lewis L. Haut, M.D., Inc
07.2013 - Current

Medical Billing Specialist

Bernard Recht, M.D.
07.2009 - 06.2013

Medical Billing Specialist

Pacific Therx
07.2005 - 07.2009

High School Diploma -

South Tahoe High

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Jena Gonzalez