Tania Rojas
San Antonio,TX
Summary
Organized Patient Service Representative with 5 years of experience in healthcare. Adept
at patient advocacy and education with commitment to efficiency. Skilled at administrative
management, and maintaining professionalism in stressful situations.
Authorized to work in the US for any employer
Overview
8
8
years of professional experience
1
1
Certification
2
2
Language
Work History
Patient Service Representative
Mpower Health
03.2022 - Current
- Mailed medical bills and determined pricing based on EOB
- Organized and kept track of self-pays that were mailed out manually
- Improved patient financial experiences by providing comprehensive guidance on payment options and assistance programs.
- Coordinated with other departments to address any discrepancies or concerns related to charge capture or data entry accuracy.
- Enhanced claim processing efficiency by verifying insurance coverage and obtaining pre-authorizations for procedures.
- Reduced errors in billing by accurately maintaining patient records with updated insurance information.
- Increased patient satisfaction by promptly addressing concerns regarding insurance coverage or billing issues.
- Achieved timely resolution of outstanding accounts through diligent follow-ups and negotiations with patients or their representatives.
- Collaborated with clinical staff to ensure accurate coding and billing procedures, mitigating discrepancies and minimizing claim denials.
Procedure
Schedule, GASTROENTEROLOGY CLINIC
San Antonio, TX
09.2021 - 02.2022
- Complete administrative patient intakes with case histories, insurance information and mandated forms
- Organize and maintain patient chart filing system to promote quick data finding for staff
- Frequently double-check patient histories and current information while scheduling follow-ups and other appointments
- Answer phone calls and messages for 2 physicians in a Gastro medical facility, scheduling appointments and handling patient inquiries
- Manage office bookkeeping with insurance billing and patient payments
- Answer telephone calls to offer office information, answer questions and direct calls to staff
- Received and routed laboratory results to correct clinical staff members
- Check which insurances need pre authorization, then call to obtain pre auth and referral number
Insurance Billing Specialist
CCM
Colorado Springs, CO
08.2020 - 08.2021
- Precisely evaluated and verified benefits and eligibility
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy
- Reviewed and verified data, including addresses, phone numbers, names, ages, and values
- Answered telephone calls to field inquiries from clients, vendors and various other callers seeking information
- Modified, updated and processed existing policies
- Assured timely verification of insurance benefits prior to patient procedures or appointments
- Maintained strong knowledge of basic medical terminology to better understand services and procedures
- Made contact with insurance carriers to discuss policies and individual patient benefits
- Observed strict procedures to protect sensitive patient information, including medical records and payment data.
Patient Service Representative
Avadyne Health
Cedar Rapids, IA
06.2016 - 07.2020
- Reviewed and corrected claim errors to facilitate smooth processing
- Have worked for 2 different Hospital billing departments
- Multitasked between 2 different Hospital systems, depending on the call
- Collected forms, insurance card and co-pay to facilitate registration process and prepare patient for appointment
- Generated monthly statements to check outstanding balances
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities
- Contacted insurance companies to discuss and resolve unpaid claims and incorrectly paid claims
- Went over Patients EOB's to help resolve any disputes and confusions
- Proficient in using old and new Hospital software like Epic and NextGen
Education
Associate - Liberal Arts & Sciences
Kirkwood Community College
May 2019
High school diploma in Diploma - undefined
Prairie High School
May 2014
Skills
- Medical Records Maintenance
- Problem resolution
- Proficient verbal and written communication
- Epic
- Medical Billing
- Technical skills
- Data Entry
- Conflict resolution
- Analytical
- Medical Terminology
- Microsoft excel /word WPM 45-50
- Knowledge of HIPPA
- Insurance Verification
- EMR Systems
- Medical Office Experience
- Customer focus & orientation — Proficient
- Responding to customer situations with sensitivity
- Full results: Proficient
- Customer service — Proficient
- June 2020
- Identifying and resolving common customer issues
- Protecting patient privacy — Proficient
- January 2022
- Understanding privacy rules and regulations associated with patient records
- Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued
- Development in any professional field
Certification
DS 169 Child Abuse Mandatory Reporter Training
January 2020 to January 2023
Recognizing Child abuse
DS 168 Dependent Adult Abuse Mandatory Reporter Training
January 2020 to January 2023
Recognizing early Adult abuse
First Aid Certification
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Quote
Happiness is when what you think, what you say, and what you do are in harmony.
Mohandas Gandhi
Timeline
Patient Service Representative
Mpower Health
03.2022 - Current
Procedure
Schedule, GASTROENTEROLOGY CLINIC
09.2021 - 02.2022
Insurance Billing Specialist
CCM
08.2020 - 08.2021
Patient Service Representative
Avadyne Health
06.2016 - 07.2020
Associate - Liberal Arts & Sciences
Kirkwood Community College
High school diploma in Diploma - undefined
Prairie High School
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