Virginia Marquez
Visalia,CA
Summary
Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Hardworking and passionate care management bringing 15+ years of experience carrying out all accounts receivable functions in high volume environments. Recognized as dedicated professional committed to continuous learning and innovation.
Overview
17
17
years of professional experience
Work History
Senior Accounts Receivable Specialist
Restorix Health
Irvine, CA
02.2024 - Current
- Developed comprehensive reports for management detailing billing trends and employee
- Assisted with staff training on practice management systems, ensuring accuracy across all team members' workloads.
- Updated and maintained patient accounts within the billing system, ensuring accurate records for future invoicing and reimbursement processes.
- Established effective relationships with insurance company representatives to expedite claim processing times
- Proficient in tracking claims, resolving billing issues and preparing account statements.
Secondary Accounts Receivable Coordinator
Restorix Health
Irvine, CA
02.2020 - 02.2024
- Expedited payment collection with timely submission of invoices and proactive communication with clients.
- Partnered with cross-functional departments to resolve discrepancies in customer accounts, promoting a cohesive work environment.
- Strengthened relationships with key clients by providing exceptional service in addressing inquiries regarding account balances or payment issues.
- Assisted in the implementation of a new accounting software system, improving overall functionality and user experience.
- Streamlined accounts receivable processes by implementing efficient tracking and reporting systems.
- Provided training to new employees on company-specific accounts receivable processes, fostering team cohesion and knowledge sharing.
- Verified discrepancies and resolved clients' billing issues
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
Revenue Cycle Coordinator
Gordian Medical Dba Restorix Health
Irvine, CA
06.2019 - 02.2020
- Coordinated cross-departmental efforts for timely resolution of account discrepancies, improving cash flow management.
- Collaborated effectively with clinical teams to address documentation issues impacting reimbursement rates, leading to higher revenues overall.
- Assisted finance department with accurate forecasting by providing detailed analysis of historical trends and current conditions.
- Actively participated in industry conferences and workshops to stay current on best practices for maximizing revenue cycle performance.
- Developed comprehensive training materials to educate staff on best practices in revenue cycle management, boosting team efficiency.
- Streamlined revenue cycle processes by implementing efficient workflow strategies and reducing claim denials.
Insurance Billing Coordinator
Gordian Medical, Inc
Irvine, CA
09.2015 - 06.2019
- Developed customized reports for management, enabling them to make more informed decisions related to insurance billing operations.
- Expedited claim approvals by effectively presenting cases to insurers while adhering to strict submission guidelines.
- Managed client account reconciliations by comparing internal records against external statements from insurers or healthcare providers, ensuring accuracy across all parties.
- Safeguarded sensitive customer information through compliance with privacy laws, maintaining trust between clients and the organization.
- Assisted in training new employees on insurance billing procedures, ensuring a seamless transition into their roles.
- Coordinated with insurance carriers to verify patient benefits and coverage, minimizing delays in payment processing.
- Contributed to the development of comprehensive billing guides for staff reference, promoting consistency in practices across the organization.
- Reduced billing errors through meticulous review of insurance claims and attention to detail.
- Enhanced claim processing efficiency by streamlining workflows and organizing documentation.
Insurance Verification Specialist Lead
Gordian Medical, Inc
Irvine, CA
03.2011 - 09.2015
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
- Enhanced claim processing efficiency by verifying insurance coverage and obtaining pre-authorizations for procedures.
- Demonstrated a high level of professionalism and attention to detail in all aspects of insurance verification specialist role, consistently exceeding performance expectations.
- Reduced errors in billing by accurately maintaining patient records with updated insurance information.
- Optimized productivity within the department by prioritizing tasks according to urgency and importance levels.
- Coordinated with care teams across various departments to ensure seamless integration of verified coverage information into overall treatment planning.
- Trained new staff on current, correct insurance verification procedures.
- Assisted in training new employees on best practices for efficient insurance verification processes and procedures.
- Implemented improvements to existing verification processes, increasing accuracy rates while reducing time spent on manual tasks.
- Streamlined workflow for medical providers by obtaining necessary referrals and authorizations for services.
- Contributed to company''s bottom line by reducing write-offs due to incorrect or outdated insurance information through diligent verification efforts.
- Performed various administrative tasks by filing, copying and faxing documents.
Insurance Verification Specialist
American Medical Technologies Dba Gordian Medical
Santa Ana, CA
11.2006 - 03.2011
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Education
Mechanical Engineering
CSU Fresno State
Fresno, CARedwood High School
Visalia, CASkills
Knowledge of HIPAA
Fraud, Waste and Abuse training
EDI/EFT set up/enrollment
ANSI ASC X12 270/271 837
CMS 1500 crosswalk 5010
Revenue Cycle Management: Billing and Collections
Ability to identify bottlenecks and streamline workflows when crosstrained
Knowledge of contract management
Denial management and appeals
ICD-10
HCPC
DME MAC
HMO, PPO
Managed Care Organizations
Commercial
State Medicaid Program
Federal program
Veteran/Tricare
Web portal management
Analytical abilities
Multi-task
Attention to detail
Quick learner
EHR
Accomplishments
Single handedly collected $350M in one quarter from primary Commercial collections
Collected $50k in secondary claims in one state Medicaid
Languages
Spanish
Native or Bilingual
Timeline
Senior Accounts Receivable Specialist
Restorix Health
02.2024 - Current
Secondary Accounts Receivable Coordinator
Restorix Health
02.2020 - 02.2024
Revenue Cycle Coordinator
Gordian Medical Dba Restorix Health
06.2019 - 02.2020
Insurance Billing Coordinator
Gordian Medical, Inc
09.2015 - 06.2019
Insurance Verification Specialist Lead
Gordian Medical, Inc
03.2011 - 09.2015
Insurance Verification Specialist
American Medical Technologies Dba Gordian Medical
11.2006 - 03.2011
Mechanical Engineering
CSU Fresno State
Redwood High School