Susana Reyes
Hemet,CA
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Organized and motivated employee eager to apply time management and organizational skills in various environments. Seeking opportunities to expand skills while facilitating company growth.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Vendor Liaison
KPC Global/KPC Health/Hemet Global Medical Center
Hemet, CA
03.2021 - Current
- Reviewed daily Explanation of Benefits to identify any discrepancies or errors in patient account balances.
- Contacted third party payers regarding unpaid claims or denied claims for further investigation and resolution.
- Conducted follow-up on outstanding insurance claims and worked with other departments to resolve payment issues.
- Generated appeals for services denied by payers and sent them out according to established timelines.
- Sent written notices to customers regarding outstanding balances or delinquencies.
- Recorded information about status of collection efforts.
- Contacted insurance companies to check status of claim payments.
- Ensured HIPAA compliance when handling confidential patient information.
- Answered incoming calls from patients regarding billing inquiries and resolved customer service issues.
- Assisted in the maintenance of patient accounts to ensure accuracy of information including demographic, insurance and financial data.
- Generated patient refund requests and submitted for supervisor approval.
- Evaluated invoices from vendors to ensure accuracy of pricing information.
- Ensured compliance of vendors to contractual obligations.
- Performed regular reconciliation of reports for existing vendors to verify accuracy of current status for outstanding accounts.
- Maintained positive working relationship with fellow staff and management.
- Answered questions and fulfilled requests with friendly and knowledgeable service.
- Back up support to Self Pay Department for all duties.
- Back up support to Receptionist for all duties.
- Provided support to other staff members as needed.
Admitting Representative
Corona Regional Medical Center
Corona, CA
01.2020 - 01.2021
- Registration of all patients in the Emergency Department
- Obtain picture identification, insurance cards, verify data in patient account to be current
- Verify insurances with hdx, onesource, insurance websites, or by calling insurance companies
- Daily use of computer programs: Invision, Cerner, Document Imaging, Outlook, Shifthound, Intranet, and Registration of outpatient services including: Labor and Delivery, Laboratory, Behavioral Health Services, and updating accounts
- Answering phones calls transferred to Emergency Department
- PBX operator coverage, answering phones, transferring calls to appropriate departments, announcing codes on intercom, documenting codes in various books, and using two-way transceiver.
Dental Practice Manager
Healthy Habit Dental & Orthodontics
Temecula, CA
01.2017 - 01.2019
- Managed dental team to efficiently treat patients in a timely manner and schedule subsequent needed appointments
- Administered daily operations including revenue collections, multiple phone line system, HMO, PPO, Medi-Cal, Denti-Cal, Accounts Payable, Accounts Receivable, Doctor’s calendar, Microsoft Office 365, SoftDent Software and Dentrix Software
- Ensured all doctor profiles are up to date with each affiliated insurance company are up to date
- Built strong relationships with various specialty offices to better serve patients
- Presented accurate treatment plans, insurance coverage explanations, and details of future appointments to patients.
Office Manager/Dental Assistant
Jenny Tsai DDS
Escondido, CA
01.2015 - 01.2019
- Presented accurate treatment plans, insurance coverage explanations, and details of future appointments to patients
- Administered daily operations including multiple phone line system, PPO, Medi-Cal, Denti-Cal, Accounts Receivable, Doctor’s calendar, Microsoft Office 365, Easy Dental Software and Dentrix Software
- Ensure all doctor profiles are up to date with each affiliated insurance company are up to date
- Built strong relationships with various specialty offices including NCOFSC, Escondido Endodontics, and Borrego Healthcare to better serve patients.
Customer Service
Avista Technologies, Inc.
San Marcos, CA
01.2007 - 01.2015
- Daily responsibilities were to answer multiple phone lines, provide accurate time frame for when products and/or water treatment membranes would ship to their respective destinations, Quickbooks, Microsoft Office 2010, AS400, and Log Books
- Maintain accurate records of shipping, receiving, creating work orders, creating bill of ladings, NAFTA, and calling freight carriers
- Excellent communication with warehouse personnel to ensure shipping and receiving procedures followed
- Assist President and Vice President with outside work hour functions such as Rose for Seniors, Adopt a Family, Active Military and Families packages, and 5k Run for Mitchell Thorpe Foundation.
Education
High School Diploma -
San Pasqual High School
01.1997
General Education -
Palomar College
General Education -
CSU San Marcos
Skills
- Fluently speak, read and write in Spanish
- Excellent knowledge of office equipment
- Competent with various computer software systems
- Strong verbal communication
- Proficient in keyboarding and 10 key
- Very knowledgeable in data entry, appointment book scheduling, accounts receivables, and accounts payables
Certification
- Certification in CPR and AED
- Water Training Certified
- Foster Parent License - 2023
Languages
Spanish
Native/ Bilingual
References
References available upon request.
Timeline
Vendor Liaison
KPC Global/KPC Health/Hemet Global Medical Center
03.2021 - Current
Admitting Representative
Corona Regional Medical Center
01.2020 - 01.2021
Dental Practice Manager
Healthy Habit Dental & Orthodontics
01.2017 - 01.2019
Office Manager/Dental Assistant
Jenny Tsai DDS
01.2015 - 01.2019
Customer Service
Avista Technologies, Inc.
01.2007 - 01.2015
High School Diploma -
San Pasqual High School
General Education -
Palomar College
General Education -
CSU San Marcos
- Certification in CPR and AED
- Water Training Certified
- Foster Parent License - 2023
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