Maria Orellana
Bowie,MD
Summary
Qualified Health Benefits Specialist seeking new opportunities. Extensive experience in managing employee health benefits programs and ensuring compliance with healthcare regulations. Demonstrated expertise in client communication and problem-solving to improve employee satisfaction and operational efficiency.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Intake & Health Benefits Specialist
La Clinica Del Pueblo
02.2016 - 12.2024
- Acknowledged as the top-performing intake worker, leading the creation and management of weekly, quarterly, and annual claims and insurance pending report, boosting accuracy and efficiency by 30% for senior leadership.
- Conducted data analysis on claims and denials, identifying trends and implementing process improvements with finance, complice, and operations teams to gather information and address audit-related concerns.
- Expert in immigration and income guidelines for insurance eligibility; assisted in identifying grants programs to secure additional resources for patients and the organization.
- Expert in medical insurance enrollment using Maryland Health connection and DC Health Link.
- Health insurance verification through various web portal with different health insurance companies.
- Maryland
AIDS Drug Assistance Program (MADAP)
- DC- AIDS Drug Assistance Program (ADAP)
- Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
- Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
- Updated patient records with accurate, current insurance policy information.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Improved communication between medical staff and patients by explaining insurance benefits and financial responsibilities.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Enhanced claim processing efficiency by verifying insurance coverage and obtaining pre-authorizations for procedures.
- Reduced errors in billing by accurately maintaining patient records with updated insurance information.
- Trained new staff on current, correct insurance verification procedures.
Medical Receptionist
La Clínica Del Pueblo
09.2008 - 01.2016
- Answer multiple telephone lines and directs calls to appropriate parties
- Schedule medical appointments, and call patients to confirm next and same day office visits
- Maintains patients accounts by verifying, obtaining, and updating demographics; including phone number, address, and pharmacy information
- Accurately keeps patient appointments on schedule by notifying provider of patient's arrival, and or, departure through eClinicalWorks system; including medical and mental health services, and laboratory
- Follow-up with patients for overdue appointments using recall system and population management
- Create Telephone Encounters (TEs) for medication refills, request of change in provider, and triage calls
- Verify insurance eligibility for Medicaid
- Process and records payments from patients for co-pays and uninsured visits
- Retrieve consult notes and other test results from Ring Central fax
- Assist with request of interpreter services for patients prior to office visit
- Responds to patient's questions regarding services offered and provides with resources about specialist facilities
- Contribute to team effort by accomplishing tasks as needed and actively participates on Patient Triads
- Experience with training new hire receptionist staff and performed other duties as assigned
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Checked patient insurance, demographic, and health history to keep information current.
- Helped patients complete necessary medical forms and documentation.
- Maintained strict confidentiality of patient information, adhering to HIPAA regulations and medical office policies.
- Managed high call volumes, directing calls to appropriate departments while maintaining a polite and professional demeanor.
- Assisted healthcare providers with administrative tasks, enabling them to focus on quality patient care.
Office Manager
Minute Photo
06.2006 - 12.2007
- Interviewed candidates for job openings make orders for photo place and inventory
- Fixed technical problems such as computer, printer or copier assist customers in pose selections and photo services
- Handled the cash register and made bank deposits
- Wrote checks for product purchased
- Maintained office atmosphere clean at all times
- Organized all materials needed for services
- Developed pictures and make enlargements upon requests program all computer
- Software and photo shop machine on daily basis
Customer Service Representative
06.2005 - 06.2006
- Handled the cash register
- Took passport pictures upon customers' requests and made several copies for client
- Maintained office atmosphere clean at all times
- Entered all orders into data system and maintained all folders organized for service
- Rendered assistance to coworkers with purchase orders
- Made business cards, flyers, brochures and invitation cards upon requests
Education
Northwestern High School
Hyattsville, Maryland06.2006
Skills
- Over sixteen years of experience in healthcare administration
- Bilingual communicator in English and Spanish
- Customer-focused service
- Detail-oriented with multitasking ability
- Proficient in eClinicalWorks EMR
- Proficient in Microsoft Word and Excel
- Data entry proficiency
- Medicaid expertise
- Insurance verification
- Staff training
- HIPAA compliance
- Attention to detail
- Multitasking
- Claims processing
- Payment posting
- Medical billing
- Data entry
Certification
Certified Application Counselor
Timeline
Intake & Health Benefits Specialist
La Clinica Del Pueblo
02.2016 - 12.2024
Medical Receptionist
La Clínica Del Pueblo
09.2008 - 01.2016
Office Manager
Minute Photo
06.2006 - 12.2007
Customer Service Representative
06.2005 - 06.2006
Northwestern High School
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