Monica Hernandez
Dallas
Summary
Motivated Patient Account Representative offering 20 years of healthcare and customer service experience. Highly effective time management, conflict resolution and communication skills.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Patient Account Representative
Guidehouse
03.2024 - Current
- Maintained high levels of data accuracy with meticulous attention to detail in processing insurance claims and updating patient records.
- Collaborated with interdisciplinary teams to optimize billing procedures and ensure timely reimbursements from insurance providers.
- Expedited claim resolutions by skillfully navigating complex insurance policies, regulations, and guidelines.
- Promoted a culture of continuous improvement within the Patient Accounts team by participating in regular staff meetings, offering constructive feedback on department processes, systems, tools for achieving objectives more effectively.
- Electronically submitted bills according to compliance guidelines.
- Enhanced team productivity by sharing knowledge, best practices, and providing cross-training opportunities for colleagues in the Patient Accounts Department.
- Worked with outside entities to resolve issues with billing, claims, and payments.
- Entered client details and notes into system for interdepartmental access and review.
- Collaborated closely with the Medical Records Department to obtain required documentation for claim submissions or appeals promptly as requested by insurance carriers.
- Increased revenue recovery rates by identifying trends in denied claims, researching root causes, implementing corrective measures to prevent future occurrences accordingly.
Insurance Claims Adjuster
Statefarm Insurance
11.2023 - 03.2024
- Improved customer satisfaction by providing timely updates and resolutions to their claims inquiries.
- Developed positive relationships with policyholders, fostering trust through transparency during the claim process.
- Identified fraudulent activities through diligent investigation, protecting company assets from potential losses.
- Fostered a supportive work environment by sharing knowledge and expertise with colleagues, promoting collaboration and teamwork.
- Assisted policyholders in understanding the complexities of their coverage plans, helping them make informed decisions about their claims.
- Answered customer questions regarding deductibles.
- Evaluated original investigation reports and documents to resolve secondary concerns.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
Patient Account Specialist II
Children's Health - Children's Medical Center Dallas
12.2014 - 11.2023
- Maintained high levels of data accuracy with meticulous attention to detail in processing insurance claims and updating patient records.
- Collaborated with interdisciplinary teams to optimize billing procedures and ensure timely reimbursements from insurance providers.
- Expedited claim resolutions by skillfully navigating complex insurance policies, regulations, and guidelines.
- Promoted a culture of continuous improvement within the Patient Accounts team by participating in regular staff meetings, offering constructive feedback on department processes, systems, tools for achieving objectives more effectively.
- Electronically submitted bills according to compliance guidelines.
- Enhanced team productivity by sharing knowledge, best practices, and providing cross-training opportunities for colleagues in the Patient Accounts Department.
- Worked with outside entities to resolve issues with billing, claims, and payments.
- Entered client details and notes into system for interdepartmental access and review.
- Collaborated closely with the Medical Records Department to obtain required documentation for claim submissions or appeals promptly as requested by insurance carriers.
- Increased revenue recovery rates by identifying trends in denied claims, researching root causes, implementing corrective measures to prevent future occurrences accordingly.
Education
No Degree - Associates in Business Management
Mountain View College
Dallas, TXSkills
- HIPAA Compliance
- Insurance Verification
- Insurance Billing
- Medical Billing
- Follow-up skills
- Strong empathy
- Team Collaboration
- Insurance collaboration
- Collections experience
- Insurance Company Communication
- Updating Customer Accounts
- Codes reviewing
- Teamwork and Collaboration
- Problem-Solving
Certification
- Public Notary
- Insurance Adjuster License
- Medical Billing and Coding Certification, exam pending
Languages
English
Full Professional
Spanish
Full Professional
Timeline
Patient Account Representative
Guidehouse
03.2024 - Current
Insurance Claims Adjuster
Statefarm Insurance
11.2023 - 03.2024
Patient Account Specialist II
Children's Health - Children's Medical Center Dallas
12.2014 - 11.2023
No Degree - Associates in Business Management
Mountain View College
- Public Notary
- Insurance Adjuster License
- Medical Billing and Coding Certification, exam pending
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