Sonia Juarez

Under close supervision, serves customers by determining requirements, answering inquiries, resolving problems, fulfilling requests, and maintaining records. Responsible for computerized patient scheduling, collection of comprehensive demographic and insurance information required to facilitate timely and accurate billing of services, obtainment of pre-certification authorization and benefit information necessary for payment. 6 Dental clinics, 26 Primary clinics,12 Specialty clinics.

Responsible for Medical Billing and Collections.

Processed 35 claims daily.

Oversaw a team of 6 employees Create new infusion patient packets and update as needed.

Check all patient infusion packets 8 days prior to scheduled infusion.

Obtain referrals and authorizations on all biolog-ic medications orders.

Create and verify orders for infusions.

Annually re-verify all patient's benefits that are on infusion services.

Customer service (60+ calls per day in-bound/outbound).

Verify all patients starting infusions.

Verify that all patients have in-network benefits and if not, have patients sign a waiver to pay.

Assist in the appeal process if need be.

Organize packets for the following day's infusions and get them to RNs.

Obtain increases in routine dosage/frequency changes.

Maintain contact as needed with outside providers regarding referrals.

Generate new patient profiles for all outside re-ferrals.

Responsible for Medical Billing and Collections

• Processed 25 claims daily

• Oversaw a team of 6 employees

• Familiar with aging reports, appeals and denials

• Greeted and registered incoming patients

• Collected applicable co-payments and verified insurance coverage

• Handled appointments, filed patient paperwork and answered the phone

• Make appropriate referrals

• Managed provider charges

• Provided discharge dates to doctor's offices, ambulance services, and insurance companies upon request

• Handled confidential patient information

• Knowledge in Medicare and Medicaid

• Software experience in Epic, Mosaic, Kronos and CBMS