Mariana Jones
Las Vegas,NV
Summary
Experienced professional with over 15 years in customer service and management. Looking for a long-term position, where I can utilize my skills and acquire new abilities. Strong inter-personal skills. Considered reliable, hard-working, professional and a valuable addition to any team.
Overview
7
7
years of professional experience
Work History
Workers Compensation Coordinator-Remote
Golden State Orthopedics & Spine
Capitola
02.2021 - Current
- Handle all workers compensation calls, faxes, scanning, and appointment scheduling
- Communicate effectively with patients, adjuster's, doctors, clinical team, attorney's, nurse case managers
- Handle Peer to Peer calls in a fast and efficient manner
- Enter clinical tracking in EHR Nextgen
- Request and receive documents, referrals, authorizations
- Submit RFA's for surgeries, pt, dme, injections and other care
- Call patients in regards to authorizations and referral status
- Receive and handle high volume of referrals
- Request interpreting services for patients
- Handle workers compensation claims for DOL
- Enter and verify insurance, case status
- Request retro authorization’s
Patient Accounts Billing
Golden State Orthopedics & Spine
Capitola
02.2020 - Current
- Provided customer service through phone, email and face to face
- Forwarded invoices to patients and attorney’s office’s
- Submitted claims electronically, faxed and/or dropped to paper
- Assisted in AR collections
- Accepted phone payment
- Entered daily clinical charges for new and existing patients
- Submitted charges for office visits, injections, casting, fracture care, MRI's, and Workers’ Compensation
- Enter co-payments and post credits
- Scrubbed patients demographics for errors
- Reviewed and confirmed diagnosis as well CPT Codes & ICD 10
- Communicated effectively with all medical staff and management
Medical Office Representative
Dignity Health Medical Group
Boulder Creek
09.2019 - 02.2020
- First point of contact, greeted and offered assistance in a friendly, pleasant manner
- Provided excellent customer service through face to face, online and phone interactions
- Handled over 45 patients in person and answered over 50 calls a day
- Collected and updated demographics, insurance information, ran eligibility with GECB, process verification and other insurance portals
- Scheduled appointments by utilizing an electronic practice management system
- Assisted back office by submitting pharmacy orders and messages to doctors
- Assisted patients with pre-op and authorizations questions
- Faxed, scanned and printed visit summaries, added charts, ROI's, into Power Chart Organizer
- Communicated directly with MA's and Physicians on a daily basis.
Printing Services Coordinator
Central California Alliance for Health
Scotts Valley
03.2017 - 08.2019
- Organized and prioritized daily task and coordinated with other departments
- Sorted and distributed claims
- Handled clinical and pharmacy mailings
- Assisted and worked closely with finance for weekly vendor and provider check run
- Assisted in designing envelopes w/ company logo with local vendors
- Proof read any outgoing material
- Responsible for printing, pamphlets, marketing material, clinic forms, meeting packets and agendas
- Front office, checked in walk-in members and referred them to Member Services
Education
Associate in Healthcare Administration -
Ashworth College
06.2024
Certification in Intro to Medical Coding -
Cabrillo College
05.2020
Computerized Business Administration -
Heritage College-Las Vegas
01.2006
Certification in Medical Front Office -
Cabrillo College
Skills
- Customer service
- Work well under pressure
- Problem-solving abilities
- Able to diffuse tough situations
- Insurance Verification
- Medical Billing
- Patient Care
- Workers' Compensation
- ICD-10
- CPT coding
Languages
Spanish - Fluent
Timeline
Workers Compensation Coordinator-Remote
Golden State Orthopedics & Spine
02.2021 - Current
Patient Accounts Billing
Golden State Orthopedics & Spine
02.2020 - Current
Medical Office Representative
Dignity Health Medical Group
09.2019 - 02.2020
Printing Services Coordinator
Central California Alliance for Health
03.2017 - 08.2019
Associate in Healthcare Administration -
Ashworth College
Certification in Intro to Medical Coding -
Cabrillo College
Computerized Business Administration -
Heritage College-Las Vegas
Certification in Medical Front Office -
Cabrillo College