Results-oriented achiever with proven ability to exceed targets and drive success in fast-paced environments. Combines strategic thinking with hands-on experience to deliver impactful solutions and enhance organizational performance.
Overview
13
13
years of professional experience
Work History
Claims Specialist
VisionWeb
03.2015 - 07.2018
Followed up with customers on unresolved issues.
Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
Evaluated and settled complex insurance claims in strict timeframes.
Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
Generated, posted and attached information to claim files.
Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
Insurance Claims Specialist
ProClaim
01.2013 - 12.2014
Handled insurance filing including correcting claims and other processes involving claims.
Evaluated and settled complex insurance claims in strict timeframes.
Optometry Technician Team Lead
McCormick Vision Source
07.2010 - 10.2014
Handled insurance filing and reimbursement with Aetna, BCBS, Cigna, Medicare and many other
Assisted accountant and manager with entering insurance payments
Customer Service and Administrative Tasks
Administered tests with medical equipment such as Optomap, GDX Scanning and Retinal Photography System
Responsible for teaching and dispensing contact lenses
Responsible for ordering inventory through various vendors such as Bausch and Lomb, Vistakon and Cooper Vision.
Input patient information and exam findings into electronic medical records system to facilitate accurate record-keeping.
Coordinated patient scheduling, monitored patient flow throughout office and properly communicated delays.
Optometric Technician/Assistant Manager of Operations
Master Eye Associates
12.2005 - 07.2010
Responsible for Customer Service and resolving patient issues
Responsible for administrative tasks and filing insurance claims with various insurance companies
Hired and trained new optometric technicians
Responsible for Data entry and calling other medical offices to obtain patient history
Responsible for ordered inventory through different vendors and teaching and dispensing contact lenses
Persuaded patients to allow the physician to perform preventative care tests, resulting in increase in revenue.
Collaborated with optometry staff to reach individual and team goals.
Operated and maintained lensometers, refraction units, auto-refractors, and visual field analyzers for patient testing.
Promoted positive and smooth patient flow throughout facility, encouraging more efficient operations and boosting patient satisfaction.
Education
University of Texas /Austin Community College
05.2014
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Connally High School
05.2003
Skills
Claims Processing
Insurance knowledge
Timeline
Claims Specialist
VisionWeb
03.2015 - 07.2018
Insurance Claims Specialist
ProClaim
01.2013 - 12.2014
Optometry Technician Team Lead
McCormick Vision Source
07.2010 - 10.2014
Optometric Technician/Assistant Manager of Operations