Kiara J. Cartagena-Rojas
Greer,SC
Summary
Detail-oriented and highly organized Medical Administrative Assistant with over 8 years of experience supporting healthcare operations in fast-paced clinical settings. Proven expertise in medical billing, insurance claim processing, referrals, patient scheduling, and front-office coordination. Skilled in managing electronic medical records (EMR), verifying insurance eligibility, and ensuring HIPAA compliance. Recognized for delivering exceptional customer service, improving office efficiency, and supporting multidisciplinary healthcare teams with professionalism and discretion.
Overview
12
12
years of professional experience
Work History
Customer Service Representative
Aeroflow Healthcare-Billing Department
, Remote
07.2024 - Current
- Analyzes denied insurance claims by identifying root causes and implementing resolution strategies.
- Managed 30 inbound calls daily from patients, offices, and referral sources.
- Guided patients through billing processes, ensuring clarity and assistance.
- Stay up-to-date on payer policies and regulatory changes to maintain compliance.
- Verified insurance eligibility while accurately entering patient data into system.
- Processed credit card payments, maintaining precise transaction records.
- Clearly explain the explanation of benefits (EOBs) and coverage details to patients.
Medical Office Receptionist
Premise Health
Greer, SC
04.2024 - 07.2024
- Documented patient medical information, case histories, and insurance details to facilitate smooth appointments and payment processing.
- Processing payments, handling insurance claims, and managing patient billing.
- Maintained patient databases, and updated information in alignment with HIPAA protocols.
- Received, recorded, and filed medical payments by check, cash, and credit card.
- Reviewed and sent medical records to other physicians upon request.
Patient Access Representative
Spartanburg Regional Hospital System
Greer, SC
03.2021 - 03.2024
- Established accurate cash drawer functions related to cash drawer reconciliation and deposit.
- Managed over 40 inbound calls per day from patients, home health offices, and insurance companies.
- Responsible for all patient and claim edits for accuracy and compliance with all government and commercial carriers, to ensure a clean claim submission.
- Ability to obtain insurance eligibility and benefit information from payors via phone, RTE, or web, in order to provide the patient with estimated responsibility for services requested or rendered.
- Accurately completed quality registration in the HIS system that maintains the integrity of demographic and financial information required for clinical and billing functions for every patient encounter.
Endoscopy Technician
Bon Secours Healthcare System
Greenville, SC
02.2020 - 11.2020
- Responsible for labeling specimens, logging them into the pathology notebook.
- Supported physicians and nursing staff during procedures.
- Enhanced efficiency in the endoscopy suite by diligently preparing rooms and equipment for procedures.
- Ensured timely completion of endoscopic procedures by effectively assisting physicians with scope insertions, biopsies, and endoscopic retrograde cholangiopancreatography.
Patient Service Representative
Prisma Health Pediatric Pulmonology
Greenville, SC
08.2019 - 02.2020
- Assists with outpatient coding, error resolution, and codes information about procedures performed and diagnoses on charge.
- Gathers charge information, codes, enters it into the database, completes the billing process, and distributes the billing information.
- Responsible for posting all payments and balancing with computer reports at day end.
- Processes unpaid accounts by contacting patients, and third-party payers.
- Verified insurance eligibility and coverage for patients.
- Responsible for complete and accurate patient registration, pre-certification, charge capture, and accurately coding diagnoses given by physicians.
Medical Assistant
Wellspan Health
York, PA
03.2018 - 07.2019
- Complete patient registration, scheduling, and billing tasks, pre-authorization, and other general office/clerical duties as assigned.
- Documents and processes prescription requests and refills per protocol.
- Enters and/or retrieves data from established computer files using knowledge of various computer software applications.
- Ensures all specimens are tracked and logged prior to transportation to the lab.
- Obtains and documents the reason for visit, patient vital signs, which may include temperature, blood pressure, weight, BMI, respirations, and pulse.
- Streamlined office operations by managing inventory levels, ordering supplies, and organizing storage areas.
Lead Sales Associate
Goodwill Industries
Lancaster, PA
11.2013 - 01.2017
- Handled cash register operations and customer transactions to process payments.
- Participate in interviewing candidates for entry-level retail roles. Contribute input to, and assist in administering, associate evaluations. Be a backup to the Assistant Manager as needed.
- Developed and maintained knowledge of current sales and promotions.
- Manage candidate flow throughout the recruitment process, including reviewing resumes, preparing candidates for interviews, scheduling interviews, and assisting with the onboarding process.
- Trained, coached, and mentored new sales associates for maximum performance.
- Report on effective sourcing and recruiting trends, and make recommendations based on data.
Education
Associate of Arts - Specialized Business
Consolidated School of Business
York, PA03.2018
Skills
- Electronic Medical Records (EMR/EHR) – eg, Epic and MedForce
- Insurance Verification & Authorization
- Medical Billing & Coding
- Claims Handling and Processing
- Collection Management
- Data Entry and Records Management
- Microsoft Office Suite (Word, Excel, Outlook)
- Payment Processing
- Medical Insurance
- Medical Terminology
- Referrals processing
Languages
Spanish
Native/ Bilingual
Timeline
Customer Service Representative
Aeroflow Healthcare-Billing Department
07.2024 - Current
Medical Office Receptionist
Premise Health
04.2024 - 07.2024
Patient Access Representative
Spartanburg Regional Hospital System
03.2021 - 03.2024
Endoscopy Technician
Bon Secours Healthcare System
02.2020 - 11.2020
Patient Service Representative
Prisma Health Pediatric Pulmonology
08.2019 - 02.2020
Medical Assistant
Wellspan Health
03.2018 - 07.2019
Lead Sales Associate
Goodwill Industries
11.2013 - 01.2017
Associate of Arts - Specialized Business
Consolidated School of Business
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