Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Miriam Melendez

Ocoee

Summary

Experienced Claim Specialist with 10 years+ of experience in the Medical Insurance Industry.

Experienced Medical Customer Service Specialist, Insurance Verification Specialist with 10 years experience+ in the Medical Industry. Proven Ability to accurately process Insurance Claims and handle customer inquiries. Ability to provide amazing customer service.

Overview

25
25
years of professional experience

Work History

Case Manager

TZ Insurance
09.2021 - Current
  • Inbound call
  • Customer service
  • Insurance Verification
  • Outgoing calls
  • Claim benefits specialist
  • Insurance Coverage verification
  • HRA special needs survey
  • Spanish Member Care Department
  • English Member Care Department
  • Medicare Advantage plans
  • Medicare Advantages Application Verification
  • Overnight experience
  • Mentor for new hires

Administrative Supervisor

ANKLE AND FOOT CENTER
11.2019 - 12.2020
  • Front desk supervisor
  • Customer service
  • Train new hires
  • Athena
  • New patient coordinador
  • Check in patients
  • Check out patients
  • Collect patients copay and balance
  • Inventory
  • Appointments scheduler
  • Insurance verification
  • Medical records
  • Billing
  • Events coordinator

Insurance Claim Specialist

MCPD Orthopedics
01.2014 - 12.2017
  • Scheduled appointments
  • Check in and out patients
  • Confirming appointments
  • Call in medications
  • New Patients appointments
  • Collect copays and pending balances
  • Medical records
  • Billing
  • Inbound calls
  • Outbounds Calls
  • Front desk manager
  • Events coordinator
  • Lunch coordinator
  • Medical Claims

Picker and Damage Claim Member

Walgreens Distribution
01.2005 - 12.2012
  • Split case
  • Stocker
  • Damage clerk claim specialist
  • Inventory
  • Active First Responder
  • Customer service

Front Desk Receptionist and Medical Assistant

Doctor Ramirez De Arrellano
01.2000 - 12.2005
  • Scheduled appointments
  • Check in and out patients
  • Treatment plans
  • Procedures scheduler
  • Call in prescription
  • Insurance verification
  • Appointments confirmation
  • Claim benefits specialist
  • Doctor Assistant

Education

High school diploma -

Lola Rodriguez De Tio
Carolina, PR
06.2000

Skills

  • Managed care
  • Open to learn new skills and growth as a professional
  • Management
  • Microsoft and Google
  • CPT Coding
  • Transcription
  • Rx to pharmacy
  • Windows
  • Microsoft
  • Intake
  • Case management
  • Medical Office
  • Leadership
  • Insurance verification
  • Bilingual ( English and Spanish)
  • E clinical work system
  • ICD-10
  • Employment Skills
  • Dental Receptionist
  • Medical Scheduling
  • Clerical experience
  • Claims Processing
  • Typing
  • Analysis skills
  • EMR Systems
  • Athenahealth
  • Medical Records
  • HIPAA
  • Medicare
  • Medicare Advantages
  • CPT coding
  • Filing
  • Analysis skills
  • HIPPA
  • ICD-9
  • Medical Billing
  • QuickBooks
  • Anatomy Knowledge
  • Medical Terminology
  • Medical Coding
  • Phone Etiquette
  • Auditing
  • Computer operation
  • Accounting
  • Microsoft PowerPoint
  • Strong Communication
  • Attention to Details
  • Analytical Abilities
  • Insurance Policies
  • Coding Systems
  • Data Entry
  • Problem solving
  • Software Proficiency
  • Time Management
  • Interpersonal Skills
  • Detail Oriented

Languages

English
Native or Bilingual
Spanish
Native or Bilingual

Timeline

Case Manager

TZ Insurance
09.2021 - Current

Administrative Supervisor

ANKLE AND FOOT CENTER
11.2019 - 12.2020

Insurance Claim Specialist

MCPD Orthopedics
01.2014 - 12.2017

Picker and Damage Claim Member

Walgreens Distribution
01.2005 - 12.2012

Front Desk Receptionist and Medical Assistant

Doctor Ramirez De Arrellano
01.2000 - 12.2005

High school diploma -

Lola Rodriguez De Tio

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Miriam Melendez