Stephanie Gomez Encarnacion
Lawrence,MA
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
22
22
years of professional experience
Work History
Health Claims Specialist
Greater Lowell Psychiatric Associates
2013.11 - Current
- Posting all insurance & patients payments.
- Review of denied or rejected claims.
- Gather necessary information to support claim appeals.
- Reviewing and monitoring statuses on submitted claims to ensure payors have received them.
- Submitted electronic/paper claims documentation for timely filing.
- Monitored and updated claims status in claims processing system.
- Responded to correspondence from insurance companies.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations
- Verified patient insurance coverage and benefits for medical claims
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt
Customer Service Representative
The CCS Companies
2007.10 - 2013.05
- Operated several different computers programs
- Assisted with payment processing, arranging payment plans and determining charges for services requested
- Worked with multiple clients such as National Grid
- Keeping record of customer interactions or transactions, recording details of inquiries, complaints, or comments as well as actions taken
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Handled customer inquiries and suggestions courteously and professionally.
- Updated account information to maintain customer records.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor
Crew Member
Dunkin Donuts
2001.06 - 2005.10
- Trained to use computerized register.
- Provided excellent customer service and assisted with training new employees.
- Assisted with translation for both employees/customers
- Worked front counter, drive-thru and other areas.
- Worked well with teammates and accepted coaching from management team.
- Took orders, prepared meals, and collected payments
Education
Certificate in Health Claims Specialist -
The Salter School
Tewksbury, MA2013
High School Diploma -
Lawrence High School
Lawrence, MA06.2003
Skills
- Medical Billing
- Medical Records
- ICD-10
- Electronic Filing System
- Microsoft Word
- Microsoft Excel
- Medical Terminology
Languages
Spanish
English
Timeline
Health Claims Specialist
Greater Lowell Psychiatric Associates
2013.11 - Current
Customer Service Representative
The CCS Companies
2007.10 - 2013.05
Crew Member
Dunkin Donuts
2001.06 - 2005.10
Certificate in Health Claims Specialist -
The Salter School
High School Diploma -
Lawrence High School
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