Hi, I’m
Ariana Cifuentes
Menifee,CA
Summary
Experience professional who has demonstrated organization, customer service, communication, and project management skills proven by 22 years of successful experience in the medical admin field. Never escaping the continuing wealth of knowledge to be obtained within an upwardly moving company. Profile Service-focused, technically skilled and hardworking Patient Account Specialist and Third-party Medical collector with 22 years of experience in the medical admin field. Advanced skills in MS Office Suite (Word, Excel, Access, PowerPoint and Outlook); demonstrated ability to learn new computer programs quickly. Expert interpersonal and communication skills - known for tactful handling of sensitive, confidential issues; ability to resolve customer complaints Ability timely completion of polished, executive-level reports and presentations. Dedicated claim specialist professional with history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
17
years of professional experience
Work History
WC -LA-CountyLos Angeles, CA
Workers Compensation Lien Claims Specialist II
12.2017 - 08.2022
Job overview
- Analyzes and processes multiple complex workers compensation claims by investigating and gather information to determine claim exposure
- Determined and negotiated settlement of claims within proper authority
- Travel to multiple WC-Boards for bill review on all scheduled lien conferences in person, maintaining excellent relationships with defense attorneys, lien claimants and judges
- Code medical bills into company system with speed and accuracy, maintaining production standards related to quantity and quality of output
- Review CPT-ICD9/10 codes, fee schedules and other resource material to determine appropriate reimbursement of billed services, including applicable fee schedule or re-pricing rational
- Communicated claim activity and processing with both claimant and client, maintaining professional client relationship
- Ensuring all claim files are properly documented and claims coding is correct
- Coordinated vendor referrals for additional investigation and litigation management
Restore MotionIrvine, CA
Patient Account Specialist & Reimbursement Collector I
06.2012 - 05.2017
Job overview
- Review self-pay accounts and process dialer on outstanding balances averaging 100 daily calls and collecting payment
- Contact insurance companies regarding claim status and processing appeals for underpaid and unpaid claims
- Processing AR report to collect unpaid balances
- Set up Durable Medical Equipment at patient’s homes
- DME Independent sales rep
- Collect on cash patients for all DME supplies
- Travel to patient’s home for equipment troubleshooting and performed quality assurance.
- Reconciled statements with patient records
- Monitored flags and resolved urgent items with accuracy and efficiency
- Utilized computer programs to create invoices, letters and other documents
- Electronically submitted bills according to compliance guidelines
- Worked with outside entities to resolve issues with billing, claims and payments
St Joseph HospitalOrange, CA
Patient Account Counselor I & II / Third-party Collector
11.2007 - 05.2012
Job overview
- Contact insurance companies regarding claim status and processing appeals for underpaid and unpaid claims
- Processing AR report to collect over 150 unpaid balances
- Resubmit claims to get process properly
- Create appeals and submit necessary correspondence to process bills
- Audit accounts for errors and make necessary corrections
- Contact insurance companies regarding claim status and processing appeals for underpaid and unpaid claims
- Processing AR report to collect unpaid balances.
- Developed and maintained courteous and effective working relationships
Revcare IncCypress, CA
Reimbursement Collector I & II
11.2004 - 10.2007
Job overview
- Review self pay accounts and process dialer on outstanding balances averaging 85 daily calls and collecting pending balances
- Contact insurance companies regarding claim status and processing appeals for underpaid and unpaid claims
- WC insurance billing and collections
- WC claims processing and investigation.
- Demonstrated respect, friendliness and willingness to help wherever needed
- Learned new skills and applied to daily tasks to improve efficiency and productivity
- Resolved conflicts and negotiated mutually beneficial agreements between parties
- Used Microsoft Word and other software tools to create documents and other communications
- Participated in team-building activities to enhance working relationships
- Carried out day-to-day duties accurately and efficiently
- Completed paperwork, recognizing discrepancies and promptly addressing for resolution
- Increased customer satisfaction by resolving issues
- Worked with customers to understand needs and provide excellent service
Education
Fullerton Community CollegeFullerton, CA
Associate of Arts from Business and management
06.2004
Anaheim High SchoolAnaheim
Graduate
06.2000
Skills
- Project Management
- Report Preparation
- Written Correspondence
- General Office Skills
- Hospital Billing
- Bilingual Customer service
- Workers Compensation Programs
Languages
Spanish
Native or Bilingual
Timeline
Workers Compensation Lien Claims Specialist II
WC -LA-County
12.2017 - 08.2022
Patient Account Specialist & Reimbursement Collector I
Restore Motion
06.2012 - 05.2017
Patient Account Counselor I & II / Third-party Collector
St Joseph Hospital
11.2007 - 05.2012
Reimbursement Collector I & II
Revcare Inc
11.2004 - 10.2007
Fullerton Community College
Associate of Arts from Business and management
Anaheim High School
Graduate