Summary
Overview
Work History
Education
Skills
Affiliations
Timeline
Generic

Patricia Baran

Arlington,TX

Summary

Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims. Responsible Medical Claims Processor with strong attention to detail and juggles multiple tasks. Bilingual go-getter committed to handling claims expeditiously. Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes.

Overview

19
19
years of professional experience

Work History

Medical Claims Examiner

Transamerica
03.2023 - Current
  • Enhanced claim processing efficiency by conducting thorough investigations and maintaining accurate documentation.
  • Streamlined workflow for faster resolution of medical claims through effective prioritization and organization.
  • Reduced errors in claim submissions by meticulously reviewing patient information and verifying insurance eligibility.
  • Collaborated with healthcare providers to obtain necessary medical records, ensuring timely and accurate claim adjudication.
  • Identified fraudulent activities by analyzing patterns, trends, and discrepancies in medical claims data.
  • Improved interdepartmental communication by fostering a collaborative environment and sharing vital information regarding complex cases.
  • Maintained compliance with industry regulations and company policies while evaluating medical claims for accuracy and legitimacy.
  • Provided exceptional customer service, addressing concerns from policyholders and answering inquiries related to their claims status.
  • Increased productivity by implementing efficient strategies for handling high volumes of medical claims daily.

Lockbox Operations Specialist

Wells Fargo Bank, N.A.
01.2022 - 01.2023
  • Enhanced team productivity by streamlining processes and implementing time-saving strategies.
  • Collaborated with cross-functional teams to achieve project goals on time and within budget.
  • Conducted thorough research to identify trends and inform decision-making for business growth initiatives.
  • Organized large-scale events, ensuring seamless execution of logistics, registration, catering, and venue management.

US State Department

Citibank
01.2018 - 12.2021

Enhanced data entry and scanning process for US passports

Scanning and imaging of applicants and photographs provided


Home Health Aide

Caregivers Plus
01.2015 - 12.2017
  • Improved patient well-being by providing compassionate and attentive personal care.
  • Assisted clients with daily living activities, enhancing their independence and quality of life.
  • Maintained a clean and safe home environment for patients, reducing falls and accidents.
  • Administered medications as prescribed, ensuring proper dosage and timely administration for optimal health outcomes.
  • Collaborated with healthcare professionals to develop individualized care plans, addressing specific needs and goals of each patient.
  • Provided emotional support to patients and families during difficult times, promoting a positive atmosphere conducive to healing.
  • Transported patients to medical appointments and social outings, fostering community engagement and overall wellbeing.
  • Monitored vital signs regularly, promptly reporting any abnormalities or concerns to supervising nurse or physician.

Home Health Aide

Caregivers Plus
10.2011 - 12.2014
  • Improved patient well-being by providing compassionate and attentive personal care.
  • Assisted clients with daily living activities, enhancing their independence and quality of life.
  • Maintained a clean and safe home environment for patients, reducing falls and accidents.

Emergency Room Technician

THR Hospital
07.2005 - 10.2010
  • Enhanced ER efficiency through proficient use of medical equipment like EKG machines, defibrillators, and vital sign monitors.
  • Assisted physicians with patient assessments, contributing to accurate diagnoses and appropriate treatment plans.
  • Supported successful code responses by quickly delivering necessary medications and supplies as needed during critical situations.
  • Prepared patients for surgery or further diagnostic testing by inserting IV lines and foley catheters as required.
  • Collaborated with interdisciplinary teams to develop comprehensive care plans for complex cases involving multiple specialists.
  • Ensured compliance with infection control protocols through rigorous adherence to proper hand hygiene practices and sanitization of equipment after each use.
  • Educated patients about discharge instructions and provided guidance on medication administration, follow-up appointments, and self-care techniques at home.

Education

Associate of Science - Nursing

El Centro College
Dallas, TX
12.2010

Skills

  • Disability Claims Process
  • Documentation Review
  • Interpersonal Abilities
  • Claims Processing Proficiency
  • Fraud Detection Skills
  • Quality Assurance
  • Medical Terminology Familiarity
  • Teamwork Orientation
  • Customer Service Focus
  • Time Management
  • Stress Management

Affiliations

  • Yoga and Exercise

Timeline

Medical Claims Examiner

Transamerica
03.2023 - Current

Lockbox Operations Specialist

Wells Fargo Bank, N.A.
01.2022 - 01.2023

US State Department

Citibank
01.2018 - 12.2021

Home Health Aide

Caregivers Plus
01.2015 - 12.2017

Home Health Aide

Caregivers Plus
10.2011 - 12.2014

Emergency Room Technician

THR Hospital
07.2005 - 10.2010

Associate of Science - Nursing

El Centro College
Patricia Baran