Corrine Mizrahy
Beaufort,SC
Summary
Detail-oriented medical receptionist with 8+ years in patient care and office administration. Expertise in HIPAA compliance and claims processing, ensuring regulatory adherence. Proven ability to enhance front office efficiency and manage patient interactions, leading to improved satisfaction. Strong work ethic and adaptability, skilled in appointment management and operational support under pressure.
Overview
18
18
years of professional experience
Work History
Claims Representative
Boston Scientific
Houston, Texas
12.2023 - Current
- Processed claims efficiently, ensuring compliance with company policies and industry regulations.
- Facilitated communication between clients and adjusters to resolve claims-related inquiries promptly.
- Conducted thorough policy reviews to verify coverage details for accuracy and clarity.
- Collaborated with team members to streamline claims processing workflows and enhance efficiency.
- Responded to customer inquiries regarding claim status and provided updates in a timely manner.
- Maintained organized records of all claims activities, ensuring easy access for audits.
- Evaluated and documented claim adjustments based on new information or policy changes.
- Utilized data entry skills to input claim information accurately into the tracking system.
- Identified opportunities for process improvements, contributing to enhanced operational efficiency.
- Resolved disputes between claimants and adjusters through effective negotiation and communication.
- Provided exceptional customer service support to ensure client satisfaction throughout the claims process.
- Conducted follow-ups with claimants to gather necessary information for claim adjudication.
- Reviewed and verified claim information to ensure accuracy of data and compliance with established policies.
- Maintained detailed records of all communication with customers, claimants, providers, and internal departments.
- Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
- Documented changes in claim statuses using specialized software systems.
- Filed appeals on behalf of customers when necessary after denial of a claim due to insufficient evidence.
- Verified details with policyholders and requested additional information.
- Collaborated with other departments to resolve billing disputes or address customer concerns quickly.
- Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
- Ensured timely submission of required documentation from claimants prior to approval of payment.
- Educated customers on their rights under state and federal regulations governing insurance policies.
- Developed strategies to reduce the number of denied or delayed claims within assigned portfolio.
- Reviewed documentation and accounts to gain full picture.
- Collaborated with healthcare providers to verify treatments and ensure accurate claim payments.
- Evaluated and processed insurance claims according to company policies and industry standards.
- Organized information by using spreadsheets, databases or word processing applications.
Eligibility Specialist
Preventice Services
Houston, Texas
10.2020 - 10.2023
- Coordinated with external agencies to facilitate client eligibility verification.
- Implemented process improvements that enhanced application review efficiency.
- Monitored compliance with regulatory changes affecting eligibility determinations.
- Developed documentation standards for reporting eligibility determinations.
- Collaborated with internal teams to streamline data management procedures.
- Processed eligibility applications using electronic management systems.
- Identified trends in application discrepancies and recommended corrective actions.
- Maintained comprehensive knowledge of program regulations, policies, and procedures.
- Verified applicant's identity and other relevant documents such as birth certificates or Social Security cards.
- Explained eligibility details and affordability options to patients with kindness and respect.
- Contacted client references and employers to determine legitimacy of applicant information.
- Monitored client accounts for any changes that could impact eligibility requirements.
- Maintained positive working relationship with fellow staff and management.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Answered questions and responded to inquiries to deliver high level of service to patients.
Front Desk Medical Receptionist
Global family Medicine
Bluffton , SC
11 2017 - 07.2019
- Managed physician calendar, including scheduling patient appointments and procedures.
- Gathered information to file appeals for [imaging services] denials and minimized inaccuracies by maintaining accurate records of approvals.
- Managed front office activities, including customer service, patient appointment management, billing and collections, and office administration.
- Created and maintained accurate and confidential patient files.
- Updated patient financial information to ensure accuracy.
- Maximized office efficiency by answering more than [3 ] incoming calls per day to provide office information and transfer calls to desired personal.
- Answered [15] average daily phone calls to schedule appointments and address patient inquiries.
- Contacted other medical facilities to confirm medical histories and prevent inaccurate diagnoses.
- Scheduled and confirmed patient appointments for diagnostic, surgical and consultation services in busy [primary ] office with [3] providers.
- Called patients to schedule [primary ] appointments, consistently double-checking information and availability.
- Addressed, documented, and responded to incoming and outgoing calls and correspondence.
- Addressed, documented, and responded to incoming and outgoing calls and correspondence.
- Interviewed patients to collect medical information and insurance details.
Insurance Billing
Team Health
Sunrise, FL
01.2016 - 11.2017
Thoroughly investigated past due invoices and minimized number of unpaid accounts.
Carefully reviewed medical records for accuracy and completion as required by insurance companies.
Strictly followed all federal and state guidelines for release of information.
Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.
Confirmed patient information, collected copays and verified insurance.
Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
Carefully reviewed medical records for accuracy and completion as required by insurance companies.
Strictly followed all federal and state guidelines for release of information.
Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.
Confirmed patient information, collected copays and verified insurance.
Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
Evaluated the accuracy of provider charges, including dates of service, procedures, level of care, locations, diagnoses, patient identification and provider signature.
Head Server/ Head Hostess
Coral Springs Diner
Pompano Beach, FL
08.2007 - 02.2016
I was in charge of seating customers.I was in charge of were and who the sever were going to work at what stations.I was a manager when the owner was not thereI would server customer with a smile and pleasant attitude
Front And Back Office Medical Assistant
Jerry Perlmutter
Margate, FL
03.2015 - 08.2015
Read and recorded temperature, pulse and respiration.
Massaged patients and applied preparations and treatments, such as liniment, alcohol rubs and heat-lamp stimulation.
Completed and submitted clinical documentation in accordance with agency guidelines.
Prepared patient rooms prior to their arrival.
Kept facility stocked with necessary supplies, equipment and instruments.
Recognized and reported abnormalities and/or changes in patients' health status to nursing staff.
Massaged patients and applied preparations and treatments, such as liniment, alcohol rubs and heat-lamp stimulation.
Completed and submitted clinical documentation in accordance with agency guidelines.
Prepared patient rooms prior to their arrival.
Kept facility stocked with necessary supplies, equipment and instruments.
Recognized and reported abnormalities and/or changes in patients' health status to nursing staff.
Office Assistant - Office Receptionist
Doctoroff Medical Office
Coral Springs, FL
12.2012 - 12.2014
Thoroughly investigated past due invoices and minimized number of unpaid accounts. Recorded and filed patient data and medical records.
Carefully reviewed medical records for accuracy and completion as required by insurance companies.
Strictly followed all federal and state guidelines for release of information.
Acquired insurance authorizations for procedures and tests ordered by the attending physician.
Scheduled patient appointments.
Monitored shared email in-boxes and ensured inquiries were addressed.
Monitored shared email in-boxes and ensured inquiries were addressed.
Monitored shared email in-boxes and ensured inquiries were addressed.
Carefully reviewed medical records for accuracy and completion as required by insurance companies.
Strictly followed all federal and state guidelines for release of information.
Acquired insurance authorizations for procedures and tests ordered by the attending physician.
Scheduled patient appointments.
Monitored shared email in-boxes and ensured inquiries were addressed.
Monitored shared email in-boxes and ensured inquiries were addressed.
Monitored shared email in-boxes and ensured inquiries were addressed.
Education
Associate of Arts - medical billing and coding
Florida Career College
2014
Skills
- Knowledge of HMOs, Medicare and Medi-Cal
- Medical Manager Software
- Electronic Medical Record (EMR) software
- HIPAA compliance
- Strong planning skills
- Patient-focused care
- Strong work ethic
- Team player with positive attitude
- Deadline-driven
- Exercises good judgment
- Maintains strict confidentiality
- Medical Manager Software
- ICD-9 coding
- Claims processing
- Insurance verification
- Patient relations
- Customer service
- Time management
- Team collaboration
- Attention to detail
- Problem solving
- Claims processing software
- Professionalism and ethics
- Medical terminology
- Insurance regulations
- Claims review
- Payments posting
- Critical thinking
- Task prioritization
- Policy requirements and eligibility
- Goal setting
- Multitasking capacity
- Electronic authorization processing
Affiliations
I was a runner up in employment of the month for Team health in February also a employment for Coral Springs Diner
References
- Lindzee Lamparter # 779-771-2970
- Laura Nambo # 936-777-0840
- Lauren Vincent # 281-315-4023
Timeline
Claims Representative
Boston Scientific
12.2023 - Current
Eligibility Specialist
Preventice Services
10.2020 - 10.2023
Insurance Billing
Team Health
01.2016 - 11.2017
Front And Back Office Medical Assistant
Jerry Perlmutter
03.2015 - 08.2015
Office Assistant - Office Receptionist
Doctoroff Medical Office
12.2012 - 12.2014
Head Server/ Head Hostess
Coral Springs Diner
08.2007 - 02.2016
Front Desk Medical Receptionist
Global family Medicine
11 2017 - 07.2019
Associate of Arts - medical billing and coding
Florida Career College