Mary Garcia
Providence,RI
Summary
Proactive Authorization Representative with extensive experience in healthcare billing and insurance verification. Demonstrated adaptability by mastering new systems quickly, enhancing productivity and revenue through accurate record-keeping and resolution of billing discrepancies. Skilled in data entry, follow-up on claims, and maintaining HIPAA compliance, offering strong problem-solving and communication abilities.
Overview
24
24
years of professional experience
Work History
Authorization Representative
American Medical Alert Corp
01.2019 - 10.2024
- Demonstrated adaptability by quickly learning new systems and processes as they were introduced within the organization.
- Enhanced overall department productivity by consistently meeting or exceeding monthly goals for completed authorizations.
Accounts Receivable Associate
Coastal Medical, INC
06.2015 - 02.2018
- Updated and maintained patient accounts within the billing system, ensuring accurate records for future invoicing and reimbursement processes.
- Enhanced revenue by identifying and resolving billing discrepancies in patient accounts.
- Reduced account receivables aging through diligent follow-up on outstanding claims and prompt resolution of denials.
- Verified insurance of patients to determine eligibility.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
Medical Billing Assistant
Optum360
07.2000 - 06.2015
- Maintained professional demeanor while communicating with patients or insurance companies to resolve payment issues, fostering positive relationships.
- Maximized reimbursement opportunities by staying current on industry trends and new billing procedures.
- Enhanced revenue collection rates with timely follow-ups on outstanding claims and appeals.
- Safeguarded patient privacy, adhering to strict HIPAA regulations during all aspects of the billing process.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility.
- Collected payments and applied to patient accounts.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Used data entry skills to accurately document and input statements.
- Entered invoices requiring payment and disbursed amounts via check, electronic transfer or bank draft.
Education
Medical Executive Assistant Certificate - Medical Executive Assistant
Katherine Gibbs Business School
Providence, RI06-1999
Skills
- Data entry proficiency
- Follow-up skills
- Multitasking
- Reliability
- Decision-making skills
- Computer Literacy
- Problem-solving aptitude
- HSYS and SalesForce expertise
- Detail orientation
- Research skills
- Communication Skills
Timeline
Authorization Representative
American Medical Alert Corp
01.2019 - 10.2024
Accounts Receivable Associate
Coastal Medical, INC
06.2015 - 02.2018
Medical Billing Assistant
Optum360
07.2000 - 06.2015
Medical Executive Assistant Certificate - Medical Executive Assistant
Katherine Gibbs Business School
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