Karen Berrios
North Hollywood,CA
Summary
Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Financial Care Specialist I
Cedars-Sinai Medical Center
01.2020 - Current
- Diligently answer high volume of calls from patients and providers, collecting payments, address billing inquiries
- Frequently contact insurances to resolve patient claims and inquire on patients benefits/eligibility
- Create insurance coverage in Registration and update patient’s personal information in EPIC
- Respond to patient messages through inbasket messages and by e-mail
- Successfully trained and onboarded new employees, helped teach new employees the basics and department workflow
- Execute the handling of multiple work queues that are worked daily and assist management with escalated accounts
- Provide refreshers to the Team and assist other team members on a regular basis
- Coordinate between our department and requests from internal departments such as the Breast Health Center and CSMG/CSHA
- Assist patients with Financial Assistance application inquiries.
- Improved client satisfaction by addressing financial concerns and providing personalized solutions.
- Streamlined financial processes for increased efficiency and accuracy in client care.
- Assist staff with Workers Comp inquiries and in creating workers comp accounts in EPIC.
Collector/Biller
Women’s Rehab Specialists Inc.
07.2019 - 12.2019
- Responsible for follow up on unpaid and underpaid claims, helped in overturning denials
- Appealed claims for numerous reasons including Non-Payment and Timely Filing
- Entered charges into billing system to begin revenue cycle, posted all insurance and patient payments for 4 different locations
- Collected on self-pay accounts, assured that patient liability was accurate by reviewing EOBs submitted by insurance companies
- Assisted the front desk with checking in and collecting patient payments
- Went over billing statements with patients.
Self-Pay Collector
South Bay GI Medical Group
04.2019 - 07.2019
- Processed and balanced all self-pay collections daily
- Reviewed charges and gave cost estimates to patients, set up payment plans
- Collected patient payments in person, and over the phone
- Contacted patients for past due invoices.
Billing Specialist
Flexogenix Group Incorporated
10.2018 - 03.2019
- Followed up on unpaid claims, appealed all denials
- Responsible for PPO, HMO, and Medicare Claims
- Responsible for billing and collecting for 6 different offices
- Responsible for assisting patients with EOB explanations and responding to insurance requests
- Reviewed all payment trends with management for a smooth workflow.
Payment Poster/ Eligibility Specialist
Team Health IPC.
05.2018 - 09.2018
- Verified patient Eligibility.
- Check claim status and bill the claim to the correct insurance. Input data from Face sheet onto our system.
- Verify claim denials.
- Work WHIN reports and code accounts with correct insurance.
- Post denials.
- Assisted the Eligibility Dept, Billing Dept and Registration Dept with keeping workflow current.
- Posted payments and reconciled batches.
Eligibility Specialist
Digestive Disease And Endoscopy Consultants
08.2015 - 05.2016
- Verified patient eligibility and benefits daily for two offices.
- Verified eligibility by phone and through insurance websites.
- Confirmed authorizations for consults and follow up visits were up to date.
Insurance Representative II
USCB Inc.
06.2012 - 08.2015
- Documented correspondence and EOBs from Insurance companies.
- Created spreadsheets to post the payments received from the insurances onto our system, Artiva.
- Appealed accounts for under payment, timely filing and capitated deductions to the health plans, medical groups, and capitated hospitals.
- Adjusted accounts that were paid correctly.
- Worked on bad debt accounts.
- Assisted with the Good Samaritan Hospital project with billing and appealing.
- Sent Patient letters to patients for non-payment.
- Verified Eligibility by phone and through the insurance websites.
- Assisted on Answering calls from patients and insurance for our Call Center.
- Worked closely with the AVP and supervisor to discuss trends in the project.
- Trained and onboarded new employees for the Customer Service Dept.
Education
Bachelor of Science - Organizational Leadership
Los Angeles Pacific University
San Dimas, CA12.2023
Health Claims Examiner/Medical Billing Certificate -
American Career College
Los Angeles, CA07.2012
High School Diploma -
Foshay Learning Center
Los Angeles, CA01.2008
Skills
- Microsoft Word
- Outlook
- PowerPoint
- Excel
- Teams
- Adobe Acrobat
- EPIC
- Cisco
- Problem Solving
- Decision Making
- Customer Service
- Microsoft Office
- Spanish Fluency
- 60 Wpm Typing Speed
- Medical Terminology Knowledge
- Billing Adjustments and Refunds
- Money Handling Abilities
- Calm and Professional Under Pressure
- Issue and Complaint Resolution
- Call Center Operations
- Problem Resolution
- Call Documentation
- Critical Thinking
- Adaptability
- Time Management
- Revenue Growth
Languages
Spanish
Certification
Standing Ovations from Patients and Staff.
Timeline
Financial Care Specialist I
Cedars-Sinai Medical Center
01.2020 - Current
Collector/Biller
Women’s Rehab Specialists Inc.
07.2019 - 12.2019
Self-Pay Collector
South Bay GI Medical Group
04.2019 - 07.2019
Billing Specialist
Flexogenix Group Incorporated
10.2018 - 03.2019
Payment Poster/ Eligibility Specialist
Team Health IPC.
05.2018 - 09.2018
Eligibility Specialist
Digestive Disease And Endoscopy Consultants
08.2015 - 05.2016
Insurance Representative II
USCB Inc.
06.2012 - 08.2015
Bachelor of Science - Organizational Leadership
Los Angeles Pacific University
Health Claims Examiner/Medical Billing Certificate -
American Career College
High School Diploma -
Foshay Learning Center
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