Perla Rios
Summary
Seeking to transition into the dynamic realm of medical billing and coding to enhance my knowledge in the healthcare field. Committed to contributing the extensive expertise acquired as a medical insurance specialist to ensure an efficient and systematic health care operation.
Overview
13
13
years of professional experience
Work History
BILINGUAL BENEFITS AND ENROLLMENT SPECIALIST
PILLARS COMMUNITY HEALTH
11.2020 - Current
- Register and schedule new patient appointments for clinical services such as medical, dental, behavioral health and psychiatry
- Verify patients' insurance coverage and eligibility through different portals or via phone prior to their appointments
- Collaborate with the billing department in reviewing and resolving denial claims
- Follow up with patients on outstanding balances and implement payment plans
- Address inquiries regarding patients' personalized insurance coverage such as deductibles, co-insurance or copays
- Maintain patient information and confidentiality in accordance with HIPPA
- Discuss slide scale fee options for patients who are underinsured/uninsured
- Assist patients with reviewing and completing Medicaid/SNAP applications to ensure all documentation is provided
- Assist patients with Medicaid redetermination process and submitting required documentation
- Maintain a detailed record of patient interaction, pending applications and eligibility determinations
- Attend weekly CMS webinars as a Certified Marketplace Navigator to stay up to date with regulations
BILINGUAL PATIENT SERVICE REPRESENTATIVE
CHICAGO FAMILY HEALTH CENTER
09.2018 - 10.2020
- Facilitated patient registration by accurately entering demographic and insurance information into EMR system
- Increased overall practice revenue by diligently collecting copayments and outstanding balances at the time of service.
- Faxed, filed, and scanned appropriate documents, and generated reports for the day
- Handled customer service inquiries in person, via telephone and through email
- Balanced deposits and credit card payments each day
- Collaborated with the clinical team to ensure proper patient care
- Answered calls and directed to the appropriate team
- Maintained a well-organized front desk, contributing to a welcoming environment for patients and visitors
BILINGUAL DENTAL RECEPTIONIST
MICHAEL E. SULLIVAN
06.2016 - 09.2018
- Reduced wait times by greeting patients upon arrival and assisting with the check-in process
- Responded to patient inquiries and concerns in a professional manner
- Improved billing accuracy by diligently verifying insurance coverage and updating patient financial records accordingly
- Maintained a clean and welcoming reception area for patients, contributing to a positive dental visit experience.
- Ensured patient privacy by adhering to all HIPAA regulations during the collection, storage, and sharing of sensitive information.
- Supported dentist in maintaining accurate documentation of treatment plans for better continuity of care between visits
- Verified methods of payment and collected payments at the time of visit
- Scheduled patient appointments in respective doctors' calendars and followed up with reminder phone calls
- Prepared patients' charts and daily schedules for the dental staff
ASSISTANT MANAGER
CULVERS
06.2011 - 06.2016
- Reviewed work procedures and operational standards to enhance efficiency and safety
- Monitored food preparation methods to ensure food was prepared and presented at an optimal level
- Experience in front of the house and back of the house
- Trained workers in food preparation, service, sanitation, and safety procedures
- Oversaw daily cash reconciliations, ensuring accurate financial reporting and minimizing discrepancies
- Handled any food complaints from guest and insured that this rare occurrence would be fix and able to bring guest back from such disapproved service
- Developed strong working relationships with staff, fostering a positive work environment
Education
CURRENTLY ENROLLED IN MEDICAL BILLING AND CODING PROGRAM (CPC CERTFICATE) -
MORTON COLLEGE
06.2023
HIGH SCHOOL DIPLOMA -
J. STERLING MORTON WEST HIGH SCHOOL
06.2013
Skills
- Fluent in Spanish and English
- Certified Marketplace Navigator
- Proficient in Medical Terminology
- Knowledge in EMR system such eCW, Athenahealth, NextGen and Dentrix
- Microsoft Office use skills (EXCEL, WORD, and POWERPOINT ETC)
- Maintain a typing speed of 75-85 WPM
Timeline
BILINGUAL BENEFITS AND ENROLLMENT SPECIALIST
PILLARS COMMUNITY HEALTH
11.2020 - Current
BILINGUAL PATIENT SERVICE REPRESENTATIVE
CHICAGO FAMILY HEALTH CENTER
09.2018 - 10.2020
BILINGUAL DENTAL RECEPTIONIST
MICHAEL E. SULLIVAN
06.2016 - 09.2018
ASSISTANT MANAGER
CULVERS
06.2011 - 06.2016
CURRENTLY ENROLLED IN MEDICAL BILLING AND CODING PROGRAM (CPC CERTFICATE) -
MORTON COLLEGE
HIGH SCHOOL DIPLOMA -
J. STERLING MORTON WEST HIGH SCHOOL
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