Sonia Hernandez
Riverview
Summary
Detail-oriented healthcare professional with 7+ years of experience in insurance verification, medical billing, and health information management. Skilled in verifying benefits, obtaining prior authorizations, and navigating EMR systems like EPIC. Adept at providing empathetic customer service to patients, providers, and payers. Proficient in Microsoft Office Suite (Word, Excel, Outlook) and committed to accuracy and compliance in fast-paced environments.
Overview
11
11
years of professional experience
Work History
Collections Representative
UHG - Optum
11.2022 - 11.2024
- Verified insurance benefits and investigated policy coverage to resolve claim discrepancies.
- Processed appeals, prior authorizations, and patient refunds, ensuring timely issue resolution.
- Maintained detailed documentation in EMR systems and adhered to HIPAA and regulatory standards.
- Delivered exceptional service to patients, providers, and insurance payers via high-volume inbound and outbound communications.
Medical Coding & Billing
Medlite Billing Solutions
07.2017 - 05.2020
- Conducted benefits verification and release of information (ROI) requests with high accuracy.
- Prepared and followed up on insurance claims, with regular use of Medicare, Medicaid protocols.
- Maintained meticulous documentation and consistently achieved collection targets.
Customer Service
Sams Club
05.2016 - 02.2018
- Delivered customer support in a fast-paced setting, addressing billing and service questions with accuracy.
- Utilized Microsoft Office tools for record tracking and member support.
Medical Receptionist
BSD Nephology & Hypertension
10.2016 - 07.2017
- Collected and verified patient insurance and demographic information.
- Supported medical record management, ensuring clarity and compliance.
- Assisted patients with appointment scheduling and insurance inquiries.
Medical Billing
Reliable Billing
01.2014 - 11.2015
- Verified insurance coverage and submitted claims via electronic and paper channels.
- Followed up on denials, corrected claims, and maintained accurate transaction logs.
Education
High School Diploma -
James J. Ferris High School
06.2009
Skills
- Health insurance benefits verification & eligibility checks
- Prior authorizations
- Strong analytical, problem-solving, and attention-to-detail skills
- Experience with EPIC and multiple healthcare systems
- CPT/ICD-10 Experience
- Bilingual – English & Spanish (fluent in both written and verbal communication)
- Multitasking Abilities
- Excellent customer service in hospital and call center environments
- Knowledgeable in Medicare, Medicaid, and third-party payer processes
- HIPAA compliance
- Proficient in Microsoft Word, Excel, Outlook; data entry & documentation
- Effective communicator with diverse patient and provider populations
Timeline
Collections Representative
UHG - Optum
11.2022 - 11.2024
Medical Coding & Billing
Medlite Billing Solutions
07.2017 - 05.2020
Medical Receptionist
BSD Nephology & Hypertension
10.2016 - 07.2017
Customer Service
Sams Club
05.2016 - 02.2018
Medical Billing
Reliable Billing
01.2014 - 11.2015
High School Diploma -
James J. Ferris High School
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