Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

MARIBEL ORTIZ

Kissimmee,FL

Summary

Reliable Customer Service Representative with extensive track record in demanding sales and account management environments. Strong presenter, communicator and problem solver working effectively and productively with diverse customers and individual needs. Ambitious Accounts technician with more than 10+ years of experience in debt collection and collections processing. Successful in following up on past due accounts and recouping unpaid balances. Outstanding negotiator skillful in creating manageable repayment plans to reduce debt.

Overview

24
24
years of professional experience

Work History

Medical Reimbursement Technician Accounts Tech

-FCCPAC-Orlando, VAMC
01.2023 - Current
  • Processed medical reimbursement requests for timely payment, ensuring satisfied clients and healthcare providers.
  • Helped identify trends in denied claims data which led to targeted staff education and continuous improvement of the reimbursement process.
  • Enhanced the efficiency of claim filing procedures by streamlining workflows and implementing new software tools.
  • Trained new team members on medical reimbursement processes, fostering a knowledgeable and competent workforce.
  • Ensured compliance with all federal regulations related to medical billing practices, protecting organizations from potential audits or penalties.
  • Developed strong knowledge of various payer systems to maximize reimbursement opportunities for clients across diverse networks.
  • Served as a liaison between healthcare providers and payers to ensure prompt resolution of any disputes or discrepancies that may have arisen during the claims process.
  • Reduced claim denials by conducting thorough research and addressing discrepancies before submission.

Call Center Customer Service Representative

Aerotek, Solutions Agency
07.2021 - 10.2021
  • Data entry of workman compensation applications
  • Reviewing documentation for continued emergency COVID funding of clients' financial information
  • Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer
  • Answered, screened and processed high volume of calls daily with call management system and web-based communications
  • Resolved customer inquiries, questions and concerns to consistently offer quality service and meet performance benchmarks
  • Delivered fast, friendly and knowledgeable service for routine questions and service complaints
  • Asked probing questions to determine service needs and accurately input information into electronic systems
  • Conferred with customers by telephone or in person to provide information about products or services and take orders
  • Referred unresolved customer grievances to designated departments for further investigation.

Customer Service Representative

Working Solutions
02.2021 - 10.2021
  • Assisting clients with troubleshooting their IRS concerns
  • Answer questions regarding tax returns with self-motivated and dependable while achieving high performance with minimal supervision
  • Training and development
  • Patient-oriented specialist
  • File/records maintenance Care Aide
  • Excellent communication
  • Team leader
  • Positive learning process
  • Setting appointments
  • Client-focused
  • Bilingual in Spanish
  • Quick learner.

Customer Product Support

Working Solutions Turbo Tax
02.2021 - 07.2021
  • File customer tax returns accurately
  • Provide customer service to clients by answering questions regarding tax returns.

Account Technician Follow up Technician

Florida Caribbean Consolidated Patients Account Center
12.2015 - 05.2020
  • Assisted claimants, providers and clients with problems or questions regarding claims
  • Processed documents within anticipated timeframes to assist senior leadership
  • Checked documentation for appropriate coding, catching errors and making revisions
  • Examined claims, records and procedures to grant approval of coverage
  • Handled modification and updating of policies
  • Coordinated and planned investigations of claims to confirm compensability and coverage
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients
  • Modified and updated existing policies and claims to reflect change in beneficiary, amount of coverage or type of insurance
  • Handled billing related activities focused on medical specialties.

Lead Administrative Support Assistant

VA Medical Center
05.2009 - 08.2010
  • Assigning work assignments for billing claims to insurance companies, monthly data reports to gather number of claims billed and dollar amounts, Supervise up to 13 employees, serve as a secretary to the supervisor for minutes of monthly meetings in the Billing Department, review claims for billing accuracy, verify insurance information for bill processing, verify correct procedure and diagnosis codes along with revenue codes for claim processing
  • Maintained accurate department and customer records
  • Scheduled appointments, meetings and events for management staff
  • Handled incoming calls and directed callers to appropriate department or employee
  • Sorted and distributed incoming faxes, letters and emails for office distribution
  • Updated system to organize office documentation, maximizing efficiency and increasing productivity.

Lead Administrative Support Assistant

VA Medical Center
02.2001 - 05.2009
  • Supervised up to 11 employees in the accounts receivable department
  • In charge of Miami and West Palm work assignment workloads
  • Assigned accounts receivable claims for follow up inquiry from 60 to 90 days and 90 days to 120 days and over
  • Follow up on work assignments for accuracy and timely follow up with insurance carriers for payment information or claim status
  • Resubmit claims when not on file with insurance carrier for payment and follow up with a phone call
  • Monthly macro reports for work duty assignments
  • Back up relief when supervisor on travel
  • Back up relief for (San Juan Lead) Miriam Diaz when on annual/sick leave
  • Served on conference calls for San Juan and West Palm VA facility
  • Follow up on diary reports to meet Part C guidelines
  • Maintained third party accounts receivable
  • Maintained information for monthly accounts receivable data and dollar amounts for the Chief Fiscal officer
  • Conducted Reviews for check payments information for VISN 8 CBO officer in San Juan via email and phone call conference for Medical Card Services and Humana Insurance companies
  • Reports on productivity workload on employees, trained, did performance evaluations for supervisor for possible promotion potential
  • Check research data for accounts receivable
  • Team player and performed other duties as assigned.

Account Technician/ Claims Examiner

VA Medical Center
07.2008 - 02.2009
  • Research claims on follow up report and call insurance for claim status of claims over 45, 90, and 120 days
  • Document all data onto claim for diary purposes from insurance carrier by date, time and name of person you have spoken to and diary claim due to dollar amount of claim
  • Phone calls to insurance company
  • Reprint claims when not on file with insurance carrier for claim processing for payment
  • Research check information thru extended check search in Vista to verify check information from insurance carrier and see if it's in the system
  • Review claims for accuracy with cpt, diagnosis code to match with data on explanation of benefits from insurance carrier
  • Decrease claims when deductible, co-pay, or coinsurance has been applied to account that do not have a payment pending on account
  • Collect close accounts with payment information after verifying payment history
  • Review for duplicate claim and decrease whenever necessary
  • Return claims to billers for processing of incorrect claims or claims requiring more information on the billing side or having them reviewed for coding concerns
  • Third Party Claims Review
  • I am a team player and perform other duties as assigned when required by the supervisor.

Medical Support Assistant

VA Medical Center
02.2006 - 07.2008
  • Scanned with CamScanner setting, telephone customer service, telephone triage relief, release of information relief, admissions clerk relief, scheduling/canceling of clinic schedules due to doctor annual/sick leave, medical clerk duties, and downloading of EKG machines thru the MUSE system to Washington, D.C
  • Throughout the years at this medical center I went from my internship to numerous positions in the medical center and acquired all the knowledge acquired to move up in the medical center to other titles with efficiency and accuracy.

Education

Vet Assistant

Southern Technical College
Orlando, FL
07.2024

Medical Secretarial Science associate degree -

Erie Business Center
Erie, PA
06.1988

Skills

  • Customer Satisfaction
  • Account Updating
  • Complaint Resolution
  • Call Center Operations
  • Eligibility Determination
  • Transcription
  • Customer Inquiries
  • Account Management
  • Customer Service
  • Data Entry
  • HIPAA Compliance
  • Patient confidentiality
  • Claims Processing
  • Insurance Verification
  • Payment posting
  • Stress Tolerance
  • Medical billing knowledge
  • Insurance understanding
  • Teamwork and Collaboration
  • Problem-Solving

Languages

Spanish
Professional Working

Timeline

Medical Reimbursement Technician Accounts Tech

-FCCPAC-Orlando, VAMC
01.2023 - Current

Call Center Customer Service Representative

Aerotek, Solutions Agency
07.2021 - 10.2021

Customer Service Representative

Working Solutions
02.2021 - 10.2021

Customer Product Support

Working Solutions Turbo Tax
02.2021 - 07.2021

Account Technician Follow up Technician

Florida Caribbean Consolidated Patients Account Center
12.2015 - 05.2020

Lead Administrative Support Assistant

VA Medical Center
05.2009 - 08.2010

Account Technician/ Claims Examiner

VA Medical Center
07.2008 - 02.2009

Medical Support Assistant

VA Medical Center
02.2006 - 07.2008

Lead Administrative Support Assistant

VA Medical Center
02.2001 - 05.2009

Vet Assistant

Southern Technical College

Medical Secretarial Science associate degree -

Erie Business Center

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MARIBEL ORTIZ