Summary
Overview
Work History
Education
Skills
LANGUAGES
Timeline
Generic

LESLY GUZMAN

Summary

Hard-working and organized problem solver with extensive office experience including data entry and accounts payable and receivables and in billing and collecting for government public assistance and private insurances. Knowledgeable of Microsoft Word, Excel and PowerPoint. Experienced in working with people on all levels and bilingual in Spanish and English.

Overview

16
16
years of professional experience

Work History

HUMAN RESOURCES/PAYROLL ADMIN

Elite Staffing Inc.
08.2016 - Current
  • Accurately respond to verbal and written inquiries received directly from temporary staff employees on employment status, assignments, policies, procedures and benefits.
  • Assist with processing of terminations for temporary staff employees.
  • Process temporary staff employees' employment verifications.
  • Record temporary staff employees' interactions and transactions, by documenting details of inquiries, complaints, comments, and actions taken.
  • Communicate with supervisors regarding any potential needs or concerns.
  • Write and distribute email, letters, faxes and forms.
  • Prepare, translate and modify documents including correspondence, reports, drafts, and emails.
  • Open, sort and distribute incoming correspondence.
  • Maintain electronic and hard copy filing system.
  • Conduct insurance benefits audits or other HR programs.
  • Assist with the preparation and processing of weekly payroll for over 300 corporate staff employees.
  • Review and ensure accuracy of approved timesheets.
  • Handle the administration of the electronic timekeeping system. Set up each employee, valid programs for each employee's charges; monitor submissions of approved timesheets.
  • Establish/maintain employee records; ensure that employee changes are entered correctly and made on a timely basis; review changes for proper authorization.
  • Perform other duties as assigned by management.

BILINGUAL CUSTOMER SERVICES REPRESENTATIVE

Altastaff/Aetna
11.2015 - 08.2016
  • Respond to customer inquiries received by telephone, Interactive Voice Response (IVR) regarding information on programs and services.
  • Record customer interactions and transactions, by documenting details of inquiries, complaints, comments, and actions taken.
  • Follow standard operating procedures to ensure consistency and accuracy.
  • Adhere to HIPAA regulations at all times.
  • Address customers' inquiries and resolve problems to ensure that appropriate changes are made.
  • Refer unresolved customer grievances to designated departments for further investigation.
  • Perform data entry accurately.
  • Perform other duties as assigned by management.
  • Assisted Clients with enrolling for coverage under the Affordable Care Act by interacting with them to provide information regarding inquiries about programs and services in English and Spanish.

BILINGUAL CUSTOMER SERVICE REPRESENTATIVE

Delta Dental of Illinois
05.2012 - 05.2015
  • Accurately respond to verbal and written inquiries and complaints directly from subscribers, providers, brokers, or group administrators.
  • Accurately process claim adjustments during the phone call and/or during regular work time.
  • Review and process claims according to established business rules that have failed computer program edits.
  • Maintain and follow up on documents for all adjustment requests, check investigations, overpayment letters and e-forms.
  • Complete and maintain daily log/forms/reports.
  • Assist in new representatives' training.
  • Accurately completes special projects assigned within specified time frames.
  • Maintain regular and punctual attendance.
  • Perform other job-related duties as assigned.

BILINGUAL RECEPTIONIST/DENTAL CLAIMS BILLING SPECIALIST

Dental Dreams
06.2009 - 04.2012
  • Managed patient appointments by scheduling, rescheduling, and canceling as needed.
  • Checked and verified patient insurance coverage and benefits.
  • Maintained accurate patient records, including medical history, treatment plans, and billing information.
  • Collected payments from patients and processing insurance claims.
  • Answered phone calls, taking messages, and directing inquiries to the appropriate staff.
  • Performed Administrative tasks such as filing paperwork, maintaining office supplies, and managing appointment reminders.
  • Examined dental claims for accuracy, including patient information, procedure codes, diagnosis codes, and billing details.
  • Analyzed patient dental plans to determine the appropriate coverage for each procedure based on policy terms.
  • Processed claims electronically or manually, applying correct payment calculations according to insurance guidelines.
  • Investigated and resolved claim issues such as coding errors, missing information, or disputed charges by communicating with dental practices and insurance companies.
  • Inputted claim data into the insurance company's system, including patient details, procedure codes, and billing codes.
  • Reviewed claims denials, identify reasons for rejection, and work to correct errors or appeal denials when necessary.
  • Ensured claims processing follows all regulatory and compliance standards related to dental billing.
  • Responded to questions from dental practices and patients regarding claim status and billing questions.

Education

Diploma - Microcomputer Business Systems

The College of Office Technology
Chicago, IL
01.2006

Skills

  • Data Entry, Accounts Payable, Accounts Receivable, Billing, Microsoft Word, Excel, PowerPoint, Bilingual, Spanish, English, Customer Service, Payroll Processing, Human Resources, HIPAA Compliance, Problem Solving, Claims Processing
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LANGUAGES

English, Spanish.

Timeline

HUMAN RESOURCES/PAYROLL ADMIN

Elite Staffing Inc.
08.2016 - Current

BILINGUAL CUSTOMER SERVICES REPRESENTATIVE

Altastaff/Aetna
11.2015 - 08.2016

BILINGUAL CUSTOMER SERVICE REPRESENTATIVE

Delta Dental of Illinois
05.2012 - 05.2015

BILINGUAL RECEPTIONIST/DENTAL CLAIMS BILLING SPECIALIST

Dental Dreams
06.2009 - 04.2012

Diploma - Microcomputer Business Systems

The College of Office Technology

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