Sergia Ventura
Garfield,USA
Summary
Detail oriented and dependable operations professional with experience coordinating time sensitive information, verifying data accuracy, managing high volume workflows, and communicating with internal teams and external partners. Known for reliability, confidentiality, and maintaining smooth daily operations in fast paced environments. Strong background in documentation control, scheduling, reporting, and process compliance.
Overview
17
17
years of professional experience
Work History
Insurance Verification Representative II
Med-Metrix
Red Bank, New Jersey
06.2023 - Current
- Verified and validated high-volume, time-sensitive account data to ensure services proceeded without delays
- Coordinated with multiple internal departments to resolve coverage issues and maintain workflow continuity
- Communicated daily with external partners and clients to obtain required documentation and confirmations
- Maintained detailed tracking logs and performance reports using Excel to meet productivity and accuracy benchmarks
- Managed sensitive information while adhering to strict compliance and documentation standards
- Identified potential issues in advance and escalated appropriately to prevent service disruptions
Account Resolution Specialist
Prime Healthcare
02.2022 - 06.2023
- Managed commercial, Medicaid, Medicare, and out-of-state accounts.
- Submitted technical appeals for incorrect or underpaid claims.
- Processed correspondence and updated patient accounts.
- Resolved COB issues and updated insurance details.
- Handled DRG downgrade appeals through all required levels.
Secretary
King of Dents LLC
07.2020 - 11.2020
- Managed office calls, emails, and daily communication.
- Prepared meeting notes, agendas, and internal documents.
- Maintained office supply levels and organized filing systems.
- Scheduled client appointments and managed master calendar.
Sales Associate
Macy's
11.2013 - 04.2014
- Assisted 60+ customers daily with product information.
- Created displays to increase sales and reduce overstock.
- Stayed current on promotions, policies, and security standards.
- Collaborated with team to exceed sales goals consistently.
Receptionist
Wireless Innovations LLC
05.2009 - 03.2011
- Directed clients to appropriate staff and resolved inquiries.
- Operated multi-line phone systems efficiently.
- Maintained appointments, calendars, and daily office workflow.
Education
Psychology -
Caldwell University
06.2013
High School Diploma -
John F. Kennedy High School
06.2007
Skills
Operations & Administrative Support
- Scheduling and coordination
- Documentation control
- Data entry and accuracy verification
- Workflow organization
- Recordkeeping and compliance
- Internal team coordination
- Client and vendor communication
Tracking & Reporting
- Excel tracking and productivity logs
- Data validation and corrections
- Report preparation
- Attention to detail in high-volume work
Systems & Tools
- Microsoft Excel
- Microsoft Word
- SharePoint
- OneNote
Professional Strengths
- Detail-oriented
- Dependable and consistent
- Organized
- Strong communicator
- Fast learner
- Team player
Timeline
Insurance Verification Representative II
Med-Metrix
06.2023 - Current
Account Resolution Specialist
Prime Healthcare
02.2022 - 06.2023
Secretary
King of Dents LLC
07.2020 - 11.2020
Sales Associate
Macy's
11.2013 - 04.2014
Receptionist
Wireless Innovations LLC
05.2009 - 03.2011
Psychology -
Caldwell University
High School Diploma -
John F. Kennedy High School