MARGARITA ROQUE
Perris,CA
Summary
Dynamic professional skilled at connecting with people and promoting products, leveraging strong communication abilities to foster positive interactions. Experienced in stock management, promotional setups, and merchandising, consistently driving sales growth. As an A/R Specialist, recognized for exceptional productivity levels and expertise in invoice processing, account reconciliation, and financial reporting while ensuring adherence to compliance standards. Core competencies include time management, problem-solving, and effective communication, all contributing to enhanced client satisfaction and seamless resolution of billing issues.
Overview
24
24
years of professional experience
Work History
Warehouse Associate
Nordstrom
Riverside, CA
09.2024 - Current
- Performed cycle counts to ensure accuracy of inventory levels.
- Communicated effectively with team members on matters related to work assignments.
- Used pallet jacks to move items to and from warehouse locations.
- Packed materials and items in designated crates and boxes and properly sealed and labeled crates.
- Assembled customer orders from stock ensuring that the correct number and types of products were picked accurately.
- Packed boxes and stock using organizational guidelines.
- Maintained accurate inventory records through manual and computerized systems.
- Labeled containers correctly for product identification purposes.
- Assisted in packaging and labeling of products for shipment.
A/R Specialist
Zymeda
Moreno Valley, CA
10.2022 - 08.2024
- Executed billing tasks and recorded information in company databases.
- Kept all patient information secure and confidential.
- Ensured timely payments by coordinating with involved parties.
- Assessed coverage details using Epic Hospital portal systems.
- Determined proper codes for medical records and patient services.
- Streamlined billing processes by coordinating directly with government programs and private insurers for timely settlements.
- Checked insurance eligibility by making appropriate phone calls.
- Responded to inquiries from internal departments related to customer accounts receivable status.
- Processed credit card payments, wire transfers, and ACH payments received from customers.
Warehouse Associate
Nordstrom
01.2021 - 09.2022
- Worked safely around moving machinery.
- Prepared orders for shipment by systematically picking, packing and labeling merchandise.
- Inspected incoming and outgoing shipments to verify accuracy and prevent errors.
- Consistently lifted materials weighing as much as 50 pounds.
- Shipped material and performed boxing, packing, labeling and preparation of related documents.
- Readied product pallets for optimal storage and shipment, carefully organizing boxes and balancing weight.
- Sorted and delivered materials to different work areas and staff.
- Packed, secured, labeled and applied postage to materials to prepare items for shipment.
- Verified orders by comparing names and quantity of items packaged with shipping documents.
- Used hand-held devices and computers to record and monitor inventory levels and completed audits to uncover and address inaccuracies
Sales floor/Cashier
Burlington Downey Ca
12.2019 - 12.2021
- Providing customer service, checking out customers, and completing returns and exchanges.
- Provide excellent customer services.
- Work on go backs.
- Making sure to keep store clean.
- In specific apparel or decor sections within stores.
- Duties include assisting customers and keeping sections clean, orderly, and appealing.
- Tasks include overseeing associates, resolving customer questions, and improving teamwork among staff.
- Helped customers complete purchases, locate items and join reward programs.
- Checked pricing, scanned items, applied discounts and printed receipts to ring up customers.
Operations Manager
Route 64 Logistics Amazon
12.2019 - 12.2020
- Managed company operations with responsibility for profit and loss, scheduling, training and inventory control.
- Trained, mentored and supported high-performing team, providing regular performance review, feedback and coaching in deficient areas.
- Analyzed strategic, core and support processes and recommended improvements to streamline processes.
- Conducted performance reviews providing coaching and feedback to benefit both company and employee.
- Established positive and effective communication among unit staff and organization leadership, reducing miscommunications and missed deadlines.
Peer Mentor
Compton Community College
09.2019 - 12.2020
- Provides student with support leadership and advice based on your knowledge and experience.
- Provide critical support and motivation for students to achieve their higher education and career goals.
- Help mentee navigate the college going pathway and understand eligibility requirements, important deadlines, and time management strategies.
- Provide tutoring as needed basis.
- As well as supporting outreaches staff in recruitment in and off campus.
- Helps students with mentor and helping with reaching the students goals.
- Shared resources, opportunities and activities to support mentee's learning and development.
- Met mentee formally, informally, in-person and virtually to offer support.
Medical Biller
Surgical Care Affiliates Ambulatory Surgery Center
12.2012 - 07.2014
- Primary functions are credit balance management, patient balance resolution and non-patient (insurance) resolution.
- Accurate and timely follow up and resolution for all accounts receivable.
- Maximized facility reimbursement.
- Understanding each payer contract and will utilize to ensure payment and received are correct.
- Handles contracted and non-contracted; Medicare, HMO, PPO, EPO, POS, Workers Com, Self-pay third party reimbursement issues.
- Works all denial corrected claims collaborating with the biller and/or Business office Manager, insurance payers and/or patient on past accounts.
- Follow center policies, procedures, and best practice for resolution and reassignment of accounts.
- Process basic knowledge of medical terminology and health insurance billing.
- Have ability to communicate effectively with patient, physicians as with co-workers.
- Process Ensuring scheduled procedures are on the patients insurance covered list and/or the patient meets self-pay criteria.
- Verifying insurance coverage, eligibility benefits, obtaining authorization and pre-cert as required by the individual insurance company.
- Familiar with and understand Medicare, Medicaid, other government payers, commercial and HMO/PPO payers guidelines and principals Responsible for calculating co-insurance estimates per the payer contract as applicable and amounts due from self-pay patients are according to the center self-pay guidelines, policies and procedures.
- Enter verification, eligibility and benefits information in the patient accounts system to include the date and time and method use to obtain the verification/eligibility information for each patient.
- The documentation will include the amount expected from patient on or before the date of service.
- Working with CPT and (ICD-9) codes.
- Collected payments and applied to patient accounts.
- Filed and updated patient information and medical records.
Medical Biller
Life Medical DME
06.2011 - 12.2012
- Assist receptionist with front office duties including heavy phones, entering patient information, calculating Medi-cal information and determining eligibility.
- Requested Rx from doctor's offices.
- Perform LA Care, Medpoint, Apple Care, Blue Cross, Blue Shield and Medicare authorizations.
- Familiar working with Same and Similar Medicare, Incontinence supplies, catheters, determining diagnosis.
- Enter diagnosis codes (ICD-9 and HCPCS) using BrightTree and Dezin.
- Post insurance payments, appeal denials, perform office billing.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted payments and collections on regular basis.
WIC Certifier
Yakima Valley Farm Workers
12.2001 - 05.2010
- Greeting over 50 clients in person and over the phone while maintaining confidentiality.
- Maintained records in form of hard files as well as electronic files.
- Determined eligibility under categorical, geographical, income, nutrition need, and checked weight, height, and iron levels.
- Issued WIC/Farmers Market checks along with Nutrition food information.
- Referral clients to community resource as needed and translate for dietitian as needed.
- Breastfeeding counselor, on call when delivered babies, hospital visits and help maintain patient with breastfeeding education.
- Teach classes for young moms as well as promoting breastfeeding in the community.
Family Home Advocate
EPIC
02.2004 - 07.2004
- Customer service work with the teacher and parents determine eligibilities for the migrant program, make sure the children has recent vision screen, hearing screen and up to date with immunizations, home visits, excel, documenting on charts, filling.
- Make referrals to agencies as needed.
Optician Assistant
Shopko Optical
03.2001 - 12.2001
- Pre-Screen patient for the Optometrist.
- Reception duties, reminder calls to patients, including filling, billing and processing insurance claims, customer service, and data entry.
Education
Bachelor of Science -
Cal State Long Beach
Long Beach, CA2021
Associate - Art
Compton Community College
Compton, CA06.2020
Medical billing - Medical Insurance Billing
UEI College
Huntington Park, CA10.2012
High School Diploma -
Continental Academy
Coral Gables, FL07.2001
Skills
- ICD-10 Proficiency
- Document Signature Verification
- Audit Procedures
- Microsoft Office 365
- Proficient in CMS-1500 and UB-04 Claims
- WIC Certification
- Terminology
- Insurance Claims Processing
- Eligibility
- Customer service
- EOB
- HMO/PPO
- Typing 40 wpm
- Efficient Appointment Coordination
- Collections
- Medicare
- Ability to work under stress
- Efficient Information Absorption
- Bilingual In English And Spanish
- Customer Service Proficiency
- Breastfeeding counselor
- Electronic Health Record Management
- Proficient in Verbal and Written Communication
- Cash Handling Proficiency
- Quality Control Implementation
- Order Fulfillment
- Data Entry Proficiency
- Payment Record Verification
- Healthcare Revenue Cycle Management
- Accounts Payable and Accounts Receivable
- Billing Systems and Software
- ICD-10 Coding
- Claims Management
- Proficient in Diagnostic Coding
- Billing Management
- Proficient 10-Key Input Skills
- Insurance Claims Process Knowledge
- Organizational Spreadsheet Skills
- Quality Assurance in Submissions
- Claims Processing Management
- Insurance confirmation
- Insurance verification
- Multitasking and organization
- Claim submission
- Patient account management
- Verbal and written communication
- Claims processing
- Ttime management
- Insurance claim processing
- Data entry proficiency
Education
true
References
References upon Request
Timeline
Warehouse Associate
Nordstrom
09.2024 - Current
A/R Specialist
Zymeda
10.2022 - 08.2024
Warehouse Associate
Nordstrom
01.2021 - 09.2022
Operations Manager
Route 64 Logistics Amazon
12.2019 - 12.2020
Sales floor/Cashier
Burlington Downey Ca
12.2019 - 12.2021
Peer Mentor
Compton Community College
09.2019 - 12.2020
Medical Biller
Surgical Care Affiliates Ambulatory Surgery Center
12.2012 - 07.2014
Medical Biller
Life Medical DME
06.2011 - 12.2012
Family Home Advocate
EPIC
02.2004 - 07.2004
WIC Certifier
Yakima Valley Farm Workers
12.2001 - 05.2010
Optician Assistant
Shopko Optical
03.2001 - 12.2001
Bachelor of Science -
Cal State Long Beach
Associate - Art
Compton Community College
Medical billing - Medical Insurance Billing
UEI College
High School Diploma -
Continental Academy