KATELYN PEREZ-BAUTISTA
Santa Clara,CA
Summary
Experienced professional seeking a full-time position that offers professional challenges. Strong interpersonal skills, excellent time management, and problem-solving abilities. Fluent in English and Spanish, enabling effective communication and connection with individuals from diverse backgrounds. Committed to delivering high-quality results and making a positive impact within a dynamic work environment.
Overview
10
10
years of professional experience
Work History
Reimbursement Specialist II
Guardant Health
12.2023 - 10.2024
- Responsible for tracking, reporting, and addressing complex outstanding claims.
- Provided exceptional customer service when responding to patient inquiries about reimbursement status and procedures.
- Manage documentation for appropriate payer communication, correspondences and insurance claim research.
- Supported company objectives by maintaining compliance with all relevant state and federal regulations governing medical billing practices.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
- Maintained patient confidentiality by adhering to strict HIPAA guidelines when handling sensitive information.
- Ensured timely payment of claims by promptly addressing and resolving any discrepancies or issues with insurance providers.
- Prevented delays and claim denials by correcting information prior to submission.
- Served people of different backgrounds with polished people skills and advanced English and Spanish abilities.
Customer Service Representative II
Santa Clara Family Health Plan
03.2019 - 12.2023
- Answer inbound and/or place outbound calls in a high call volume environment and work directly with members and providers to answer inquiries involving eligibility accurately and completely, program services, medical and pharmacy benefits and how to access services
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Follow established guidelines and resources to respond to member and provider inquiries and resolve concerns in an accurate, timely, professional, and culturally competent manner
- Triage member and provider requests or inquiries for other departments
- Assist providers with checking claim and appeal status
Temp
Randstad- Temp Agency
08.2018 - 03.2019
- Worked at Santa Clara Family Health Plan - Customer Service Representative I
Front Desk Clerk
Mariani's Inn and Restaurant
03.2018 - 08.2018
- Handled guest complaints professionally, resolving issues quickly to maintain high levels of satisfaction.
- Greeted guests at front desk and engaged in pleasant conversations while managing check-in process.
- Assisted the restaurant staff with catering events
- Cleaned the empty rooms after guests checked out
- Print daily reports, count register and post daily deposits
Medical Administrative Assistant / Medical Biller/ Office Manager
Said Mostafavi, M.D.
01.2015 - 03.2018
- Handled sensitive patient information with discretion, adhering to strict HIPAA guidelines and safeguarding privacy at all times.
- Greeted patients and provided required paperwork to facilitate services.
- Provided exceptional customer service to patients, addressing concerns promptly and professionally to ensure satisfaction.
- Called patients to confirm scheduled appointments day in advance.
- Answered incoming calls, routed messages and resolved patient inquiries within target timeframes.
- Supported healthcare providers with the timely completion of necessary documentation, allowing them to focus on quality patient care.
- Generated reports and logged patient information for reliable records.
- Managed incoming phone calls efficiently, directing callers to appropriate personnel while providing courteous service at all times.
- Verified insurance coverage to prepare for upcoming patient appointments.
- Documented patient medical information, case histories, and insurance details to facilitate smooth appointments and payment processing.
- Demonstrated proficiency in various medical software programs, adeptly adapting to new technology as required for optimal job performance.
- Assisted in the training of new administrative staff members, sharing expertise and best practices to support their professional development.
- Streamlined front desk operations through the implementation of an effective filing system for patient documentation.
- Anticipated supply needs and placed orders proactively, preventing shortages that could disrupt daily clinic operations or compromise patient care quality.
- Conducted insurance verification and preauthorizations and managed patient charts.
- Facilitated seamless communication between patients and healthcare providers through diligent message relay and prompt follow-up actions as needed.
Education
Associate of Science Degree - Health Sciences - Medical Office and Billing Specialist
Ultimate Medical Academy
Clearwater05.2016
Diploma - Medical Assisting
Everest College
San Jose, CA12.2009
Skills
- Appeals Handling
- HIPAA Compliance
- Claims Processing
- Insurance Verification
- Denial Management
- Medicare knowledge
- Medicaid knowledge
- Eligibility Verification
- Copay Collection
- Healthcare Industry
- Medical Billing
- Payment posting
References
- Melissa Garnica, Co-worker, Santa Clara Family Health Plan, 4+ year work relationship, 408-829-9001, Lissa_246@yahoo.com
- Michelle Dumont, Co-worker, Santa Clara Family Health Plan, 4+ year work relationship, 669-346-1364, chellelynn76@gmail.com
- Anthony Booker, Supervisor, Santa Clara Family Health Plan, 4+ year work relationship, 510-449-9430, abooker@scfhp.com
- Tina Mai, Co-Worker, Santa Clara Family Health Plan, 4+ year work relationship, 408-600-9599, tinaxmai@yahoo.com
Timeline
Reimbursement Specialist II
Guardant Health
12.2023 - 10.2024
Customer Service Representative II
Santa Clara Family Health Plan
03.2019 - 12.2023
Temp
Randstad- Temp Agency
08.2018 - 03.2019
Front Desk Clerk
Mariani's Inn and Restaurant
03.2018 - 08.2018
Medical Administrative Assistant / Medical Biller/ Office Manager
Said Mostafavi, M.D.
01.2015 - 03.2018
Associate of Science Degree - Health Sciences - Medical Office and Billing Specialist
Ultimate Medical Academy
Diploma - Medical Assisting
Everest College
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