Maria Gutierrez
Homestead
Summary
Healthcare professional possessing in-depth knowledge of various insurance plans and policies. Expertise in handling high volume of calls, efficiently resolving disputes and identifying ways to improve processes while at the same time maintaining good relations with providers. Communicative and detail-oriented individual with excellent interpersonal abilities. Successfully optimizes services, resolves billing inquiries and reviews data quality.
Overview
9
9
years of professional experience
Work History
Provider Relations Coordinator
Provider Network Solutions
03.2023 - Current
- Provide oversight on inquiries and claim issues following up with corresponding departments and network groups and ensure issues have been resolved.
- Review and process all incoming and outgoing paperwork for existing groups and networks. Update email requests in accordance to each department.
- Audit of all submitted requests, associated documents, and files according to each department’s Policies and Procedures from all health groups.
- Maintain and record demographical changes, terminations, new lines of business, new service locations for existing providers, and reimbursement changes or any other updates necessary.
- Collect bi-weekly Group Attestations and ensure they are received back and signed by the groups in a timely manner in order to keep database up to date.
Lead Receptionist
Cornerstone Psychiatric Center
02.2021 - 03.2023
- Detailed oriented receptionist working independently providing optimal customer service
- Assisted with performing administrative front desk tasks, including scheduling appointments for patients
- In charge of benefit coverage, coinsurance, deductible, copayments, and obtain authorizations for office visit, and respectfully but firmly request co-pays and or outstanding balance at the time of check in
- Reviewed prescription authorizations and refills and explained physician notes and test results to patients
- Restocked supplies and submitted purchase orders to maintain stock levels.
- Screened visitors and issued badges to maintain safety and security.
Receptionist/Office Assistant
Cardiovascular Specialists Of South Florida
10.2018 - 02.2021
- Receiving 40+ calls per day and redirecting them to the to the appropriate department, taking and relaying messages to correct person
- Balance at the end of day deposits and complete credit card processing in practices designated system
- Performed duties as filing, photocopying, and faxing for then 40+ patients daily
- Explain procedures, give pre and post op instructions, increase patient satisfaction by 50%
- Maintain safety and hygiene standards of the reception area by 20%, giving patient the security needed
Receptionist
South Florida Infectious Disease
12.2014 - 03.2016
- Responded to inquiries from callers seeking information.
- Restocked supplies and submitted purchase orders to maintain stock levels.
- Confirmed appointments, communicated with clients, and updated client records.
- Answered central telephone system and directed calls accordingly.
Education
Bachelor of Arts - Health Services Administration
Florida International University
Miami, FL12.2016
Skills
- Provider relationship management
- Provider support
- Customer Service
- Service Optimization
- Relationship Management
- Health plan operations
- Goal-Oriented
- Email and Telephone Etiquette
- Attention to Detail
- Results-Driven
- Verbal and written communication
- Dispute Resolution
Timeline
Provider Relations Coordinator
Provider Network Solutions
03.2023 - Current
Lead Receptionist
Cornerstone Psychiatric Center
02.2021 - 03.2023
Receptionist/Office Assistant
Cardiovascular Specialists Of South Florida
10.2018 - 02.2021
Receptionist
South Florida Infectious Disease
12.2014 - 03.2016
Bachelor of Arts - Health Services Administration
Florida International University
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