Martha Andujar
Blue Cross/Blue Shield of Arizona
Tucson,AZ
1
Language
9
years of professional experience
Detail-oriented healthcare professional with experience in medical billing, insurance billing, and front desk support. Skilled in customer service, data entry, and billing issue resolution. Known for clear communication with patients and providers, accurate insurance verification, and strong HIPAA compliance.
Work History
Medical Biller
1 Year 4 Months- Processed claim submissions through billing systems, maintaining compliance with payer guidelines.
- Reviewed medical claims for coding accuracy, eligibility, and reimbursement requirements.
- Resolved denied claims by researching errors and correcting supporting documentation.
- Communicated with patients and providers to clarify balances, coverage, and billing questions.
Front Desk Medical Receptionist
2 Years- Greeted patients and visitors, delivering courteous front desk support in fast-paced medical office settings.
- Answered multi-line phones, routed calls, and resolved routine patient inquiries promptly.
- Scheduled appointments and coordinated calendar changes to maintain efficient patient flow.
- Verified insurance eligibility and collected demographic information with accuracy.
- Updated electronic health records with complete registration and intake information.
- Scanned, indexed, and organized medical documents to support accurate recordkeeping.
- Helped patients complete necessary medical forms and documentation.
- Ensured HIPAA compliance by maintaining strict confidentiality with all patient records and information.
Customer Advocate Specialist
9 Months- Resolved member inquiries regarding benefits, eligibility, claims, and prior authorization with accurate policy guidance.
- Documented case activity in CRM systems, maintaining compliant records and clear follow-up actions.
- Navigated complex escalations, coordinating with internal teams to deliver timely issue resolution.
- Explained healthcare plan details to members and providers, improving understanding of coverage requirements.
- Applied HIPAA and company standards while handling sensitive member information and confidential communications.
- Managed high-volume calls with consistent professionalism, empathy, and effective problem-solving.
- Enhanced customer satisfaction by promptly addressing concerns and providing effective solutions.
Program Service Evaluator
8 Months- Evaluated program service cases for policy compliance and accuracy.
- Reviewed client records to verify eligibility and supporting documentation.
- Analyzed service data to identify processing errors and improvement opportunities.
- Prepared clear reports summarizing findings, trends, and corrective actions.
Customer Service Advocate
1 Year 9 Months- Resolved member inquiries regarding benefits, eligibility, and claims using policy guidelines.
- Documented call outcomes and case notes accurately within CRM systems.
- Educated members on plan options, prior authorization, and care coordination processes.
- Escalated complex service issues to appropriate departments for timely resolution.
- Maintained compliance with HIPAA, confidentiality, and customer service standards.
- Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
- Managed high call volume during peak hours, prioritizing urgent cases while maintaining attention to detail.
Education
No Degree - Medical Administration Assistant
- 3.9 GPA
- Ambassadors Member
Skills
Insurance claims
Insurance billing processes
Medical billing
Electronic claims
HIPAA compliance
Patient billing
Claim denial management
Patient support
Billing procedures
Medical coding
Claim submission
Data entry
Languages
Spanish
Native or Bilingual
Timeline
Medical Biller
Blue Cross/Blue Shield of Arizona
05.2025 - 09.2026Read More
Front Desk Medical Receptionist
Banner Health
03.2023 - 03.2025Read More
Customer Advocate Specialist
United Health Group, Optum
10.2021 - 07.2022Read More
Program Service Evaluator
Dept of Arizona Economic Security
01.2021 - 09.2021Read More
Customer Service Advocate
Centene Corporation
10.2017 - 07.2019Read More
Everest College
No Degree from Medical Administration Assistant
Read More