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
Los Gatos, CA
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
San Jose
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.
Sunnyvale, CA
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
Portola Valley, CA
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