Veronica Caraballo
Patient Advocate
Iselin,NJ
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Detail-oriented team player with strong organizational skills.
Overview
27
27
years of professional experience
4
4
years of post-secondary education
Work History
Patient Advocate
ACCURATE MEDICAL DIAGNOSTIC SERVICES RADIOLOGY
05.2015 - Current
- Schedule patients for appointments
- Followed document protocols to safeguard confidentiality of patient records.
- Verify patient authorizations
- Assisted patients in understanding individual rights and responsibilities in regards to care, coverage, and payment.
- Entered details into computer systems and managed database of information.
- Responded to patient concerns and questions with compassionate and knowledgeable service.
- Maintained patient records and updated electronic health systems to safeguard data.
- Collected and analyzed patient feedback to evaluate quality of care.
- Collaborated with healthcare professionals to facilitate high-quality comprehensive care.
- Developed patient-centered care plans to meet individual needs.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Provided excellent customer service to patients and medical staff.
- Verified patient insurance eligibility and entered patient information into system.
- Organized patient records and database to facilitate information storage and retrieval.
- Trained new staff on filing, phone etiquette and other office duties.
- Compiled and maintained patient medical records to keep information complete and up-to-date.
- Responded to inquiries by directing calls to appropriate personnel.
- Greeted and assisted patients with check-in procedures.
- Engaged with patients to provide critical information.
- Delivered support to medical staff in completion of patient paperwork.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Answered incoming calls, scheduled appointments and filed medical records.
Credentialing Coordinator/Billing Specialist/ Patient Advocate
SPINE & PAIN CONSULTANTS OF NEW YORK
04.2012 - 01.2015
- Post and process payments from both patients and Insurance
- Provide insurances with Doctors Credentials
- Work on providing signed liens to Attorneys
- Send claims for Arbitration
- Prepare Doctors C.V
- And certificates for CAQH website
- Apply for Doctors to have hospital privileges
- Work on all refunds for patients and insurances
- Submit medical bills to the appropriate insurance company
- Work daily on explanation of benefits
- Mail correspondence letters to patients
- Keep a log of when the Doctor’s certificate or licenses will expire
- Renew license and or certificates for doctors
- Apply for DEA and NPI for all Doctors, Physician Assistant & Nurse Practitioners
- Fill out applications for doctors to get credentialed with insurances Follow up on the status of credentialing contracts
- Verify insurance eligibility Verify if authorization is needed for any procedures.
Billing Representative
METRO-MEDICAL MANAGEMENT
09.2011 - 12.2011
- Coded daily charges for various different doctors
- Posted and processed payments from both patients and insurances
- Appealed claims that have been denied
- Updated patient’s demographics
- Mailed out end of month statements to patients
- Resubmit claims that have been denied
- Balanced out for the end of day close.
Billing Representative
LASER AND SKIN SURGEY CENTER
11.2010 - 09.2011
- Submit medical bills to appropriate insurance company
- Appeal and resubmit any claims that have denied with requested information
- Collect any co-pays or insurance deductibles due from patient
- Work with insurance company on getting insurance accounts paid
- Update insurance information for patients
- Work daily on explanation of benefits
- Post payments from either the patients or insurance company to any outstanding account balance
- Refund patients as well as insurance companies any overpayments made on their behalf
- Collect the contracted rate payment from patients who are non-participating with any of the doctors
- Posted CPT Code to appropriate procedures as well as ICD9 codes
- Assist doctors with giving patients price quotes for cosmetic and non-cosmetic procedures
- Charge patients and collect payment for any cosmetic procedures patient has done that day
- Work daily on doctors auditing
- Post any procedures and payments done after close of busy the next day
- Balance out for the end of day close.
Medical Assistant & Billing Representative
DR. KEVIN K. LEE M.D. UROLOGIST
04.2009 - 06.2010
- Responsible for Medicare & Medicaid electronic submission as well as all other medical insurances using ICD9 and CPT coding
- Posted daily insurance checks and patient payments
- Assist Dr
- With the examination of the patients
- Updated changes of insurance information for patients
- Account submission to collection agency via monthly reports as well as account write-offs to collections
- Scheduled patient appointments
- Daily work on Explanation of Benefits
- Assist patients to examination rooms
- Updated patient address changes
- Working and resolving appeals on claims not paid
- Ordered and purchased non-medical office supplies
- Answered patient billing questions via phone or in person
- Prepared daily deposits
- Prepared urinalysis for the Dr
- To examine.
Accounts Receivable Specialist
QUALITY ASSURED SERVICES, DME
03.2007 - 03.2009
- Reviewed AR reports to determine status of delinquent accounts, initiates collection action by contacting insurance companies and customers
- Researched delinquent balances and reports to supervisor any corrections regarding misapplied payment, over payments, contract discounts or hardships waivers
- Data Entry on charges and accounts Researched Explanation of Benefits and corresponds with insurance carriers regarding discrepancy of rejected claims or claims processed in error by insurance
- Communicated with customer on invoicing, billing, EOB notifications or insurance Communicated with claims filer on delinquent account, which requires special re-bill handling
- Appealed claims paid at unacceptable allowable or different than expected benefit level
- Requested authorizations on any claims sent out without authorizations
- Reviewed delinquent accounts and determine the need to process through collection agencies.
Medical Bill Collector-Business Office
HIGHLANDS REGIONAL MEDICAL CENTER, HOSPITAL
05.2006 - 03.2007
- Responsible for calling insurance companies as well as patients in retrieving payments on outstanding medical bills
- Obtained authorizations and approvals for treatments on patients
- Verified current address and health insurance information for patients
- Billed primary as well as secondary insurance companies medical UB92 invoices
- Kept track of daily payments, order and retrieve medical records
- Data Entry Created spreadsheets on excel with account balances, patient information and insurance company
- Answered patient phone calls and help with any questions or concerns
- Requested Explanation of Bill payments from insurance companies and appealed any bills that were denied
- Made adjustments, write offs and outstanding balances.
Administrative Assistant/File Administrator – Project Finance & Utilities
BNPPARIBAS, FINANCIAL INSITUTION
11.1997 - 04.2006
- Primarily responsible for the recordation of compliance and legal documentation, and the file maintenance of the portfolio assigned to the ECEP-Collateral Management Team
- Input the customer details of each deal to the compliance database i.e
- Address, telephone, fax contact and other pertinent information of: Borrower, Lender, Legal Counsel, Sponsor, etc
- Input the receipt of legal documentation to the compliance database and generate a log report for review by the senior level position
- Prepare copies of legal documentation for departmental credit files and distribute the original documentation to Credit Administration
- Daily data entry
- Log the receipt of required covenant compliance documentation to the compliance database
- Generate the Compliance Past Due Reports Distribute required documentation to the Syndicate
- Other duties included maintaining and booking travel arrangements
- Scheduling, preparing and arranging conference room meetings.
Skills
- Task Prioritization
- Relationship Building
- Self-Directed
- Active Listening
- Good Telephone Etiquette
- Customer Service
- Problem-Solving
- Organization and Time Management
- Multitasking Abilities
- Computer Skills
- Data Entry
- Flexible and Adaptable
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Education
High School Diploma -
Bushwick High School
Brooklyn, NY 09.1988 - 06.1992
Timeline
Patient Advocate
ACCURATE MEDICAL DIAGNOSTIC SERVICES RADIOLOGY
05.2015 - Current
Credentialing Coordinator/Billing Specialist/ Patient Advocate
SPINE & PAIN CONSULTANTS OF NEW YORK
04.2012 - 01.2015
Billing Representative
METRO-MEDICAL MANAGEMENT
09.2011 - 12.2011
Billing Representative
LASER AND SKIN SURGEY CENTER
11.2010 - 09.2011
Medical Assistant & Billing Representative
DR. KEVIN K. LEE M.D. UROLOGIST
04.2009 - 06.2010
Accounts Receivable Specialist
QUALITY ASSURED SERVICES, DME
03.2007 - 03.2009
Medical Bill Collector-Business Office
HIGHLANDS REGIONAL MEDICAL CENTER, HOSPITAL
05.2006 - 03.2007
Administrative Assistant/File Administrator – Project Finance & Utilities
BNPPARIBAS, FINANCIAL INSITUTION
11.1997 - 04.2006
High School Diploma -
Bushwick High School
09.1988 - 06.1992
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