Karen Anne Valles
El Paso
Summary
Document Control Coordinator with a proven track record at Option Care Health, enhancing document processes and ensuring regulatory compliance. Skilled in insurance verification and customer service, I excel in problem-solving and attention to detail, successfully implementing improvements that streamline operations and enhance data accuracy.
Results-focused professional prepared to excel in document management and coordination. Proven track record in maintaining accurate and compliant documentation processes, ensuring seamless project workflow. Exceptional in fostering collaborative environments and adapting to dynamic project needs with strong organizational and communication skills.
Overview
13
13
years of professional experience
Work History
Document Control Coordinator
Option Care Health
10.2022 - Current
- Evaluated current document processes, suggested methods for change and implemented successful improvements.
- Indexed referral documents and assigned them to the appropriate department.
- Intake department - add new referrals and index all documents that are assigned to the patient.
- Process InBox referrals, authorizations, insurance cards, insurance forms, pharmacy orders, enteral orders, TPN orders and any other documents needed to complete referral.
- Verified Medical Insurance Benefits - First worked as a Insurance Specialist.
- Updated any Insurance Information
- Updated patient demographics
Insurance Follow Up Representative
GetixHealth
03.2021 - 07.2022
- Streamlined coordination between medical providers and insurance companies by serving as a reliable point of contact for all claim-related matters.
- Expedited claim settlements by efficiently addressing inquiries from both patients and insurance companies regarding billing disputes or payment arrangements.
- Served as friendly first point of contact for customer inquires.
- Met and exceeded daily service quality and performance goals.
- Made informed decisions under stressful circumstances.
- Update insurance information.
- Worked with different insurance companies to process billing with additional information needed.
- Processed credits for patients and insurance companies.
Medical Records Specialist
Brigham City Community Hospital
12.2019 - 08.2020
- Communicated effectively with staff, patients, and insurance companies by email and telephone.
- Coordinated responses to subpoenas and other legal requests for medical records, working closely with legal counsel as necessary to protect patient privacy rights.
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Uploaded physician progress notes, history, and physicals into electronic medical records.
- Maintained patient records in compliance with security regulations.
- Reviewed charts and flagged incomplete or inaccurate information.
- Scanned records and converted into electronic medical records.
Medical Billing Specialist
Children's Hospital Colorado Anschutz Medical Campus, Aurora
05.2017 - 10.2018
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted and adjusted payments from insurance companies.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Located errors and promptly refiled rejected claims.
- Assisted patients with understanding their medical bills and provided clarification on complex insurance issues, promoting a positive customer experience.
- Identified and resolved patient billing and payment issues.
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Ensured timely submission of claims to various insurance carriers, resulting in prompt payment for services rendered.
- Managed patient accounts effectively, resolving discrepancies and addressing outstanding balances in a timely manner.
- Collected payments and applied to patient accounts.
Medical Office Manager
Aurora Plastic Surgery
05.2012 - 11.2016
- Assessed processes and procedures, complying with OSHA, and HIPAA regulations.
- Managed daily administrative tasks to ensure smooth operations within the medical office environment.
- Maintained strict confidentiality of sensitive patient information, adhering to HIPAA guidelines and safeguarding against potential data breaches.
- Created and managed electronic patient records, encompassing data entry and administrative functions related to insurance, billing, and accounts receivable.
- Assisted physicians with clinical documentation to ensure complete and accurate records for each patient visit.
- Addressed and remedied all patient or team member issues.
- Maintained up-to-date knowledge of healthcare regulations and policies, ensuring the practice remained in compliance at all times.
- Provided proper scheduling of patients, ensuring timely, and effective allocation of resources and calendars.
Education
High School Diploma -
Riverside High School
El Paso, TX05-1984
Skills
- Document control
- Records management
- Quality assurance
- Regulatory compliance
- Insurance verification
- Data entry
- Medical billing
- Electronic filing
- Customer service
- Coordination skills
- Communication skills
- Problem solving
- Attention to detail
- Data accuracy
- Document organization
Timeline
Document Control Coordinator
Option Care Health
10.2022 - Current
Insurance Follow Up Representative
GetixHealth
03.2021 - 07.2022
Medical Records Specialist
Brigham City Community Hospital
12.2019 - 08.2020
Medical Billing Specialist
Children's Hospital Colorado Anschutz Medical Campus, Aurora
05.2017 - 10.2018
Medical Office Manager
Aurora Plastic Surgery
05.2012 - 11.2016
High School Diploma -
Riverside High School
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