Karla Merida

Simi Valley, CA ***** H: 805-***-**** advnx3@r.postjobfree.com

Summary

Enthusiastic Administrative Assistant with excellent people skills and dedicated work ethic. Excellent skills in complex analytical problem solving, strategic planning, project management and change management. Solution orientated, with record of accomplishment in identifying and implementing creative solutions.

Skills

• ICD-9, CPT-10 Codes, Records Data Input, Core Filing System, Scanner/Copier Literate, Laboratory Process and Bilingual English/Spanish.

• Medical Terminology, Verifying Medical Insurance HMO/PPO benefits, Online Claim Submission, Medical Software Keyboarding, Patient Online Portal, Provider Search.

• Claims handing, provider or payment preferred and 10 key, Confidentiality DME Medical Supplies.

• Proficient in Microsoft Office applications Microsoft Word Excel spreadsheets, Microsoft PowerPoint Microsoft Outlook and Adobe Reader, Mac Pro Apple, Organization Emphasis, Sale Force, Epic, Referral Portal, DOFR View, Microsoft Teams, Cisco Finesse IP, Optum Citrix, Touch Work.

• Ability to maintain confidentiality regarding patient and employee information, work tactfully and effectively with fellow staff members, physicians and the patient population and ability to work independently with minimal supervision, assess critical situations and make appropriate referrals.

• HR Administration, Exceptional Work Ethics, Organized, Team Player, Flexible and Adaptable, Routine Administrative Procedures, Type 55 wpm.

• V-Lookups, Formulas and Pivot tables Access, Outlook, Visio, QHMO, REA, Excel Score: 95%

• Organize and prioritize work efficiently, knowledge of various software programs and demonstrated ability of general secretarial duties and Experience with Electronic Medical Records System and standard PC software applications required.

• CPR/First Aid Certified

• Organize and prioritize work efficiently, knowledge of various software programs and demonstrated ability of general secretarial duties and Experience with Electronic Medical Records System and standard PC software applications required.

Customer Service Billing Representative 08/21 Present

Zotec Partners Remote Simi Valley, CA

Answer heavy high volume inbound calls, Heavy customer-oriented environment, resolve billing inquires, Insurance EOB’s and Payment Plans

Assist patient’s with health insurance, and performing varied task.

Write off death claims, and correct balances to reflex corrected claims.

Request for PI on patients accts for missing payments and insurance missing payment.

Submitting billing data and medical claims to insurances companies.

Ensuring each patient’s medical information is accurate and up to date.

Send billing statement to patients when requested.

Processing payment for patient’s, and verifying insurance.

Performing collection duties, providing discount to patient’s that has no insurance.

Professionally exercises discretion and independent judgement in day-to day work.

Loan Processor/Title Clerk 07/2020 to 9/2020

Robert Half Staffing Agency Westlake Village, CA

Audit contract packages and review documents for accuracy and identify for discrepancies.

Verification of Employments, Insurance, References, Residence.

Ordering Credit Report, Proof of Social Security, Employment and Earning reports, request Stipulations.

Conducting interview and maintain confidentiality of customer loan information.

Request for SOF on Recalls, Dealership verification along with Valid Reg, KBB and Master Dealer Enrollments.

Communicated with dealership loan application and clients.

Title organized dealership records in effected matter, Verifies funds have been collected and correct lienholder payoff before processing title applications, title documents to transfers ownership of property.

Answers incoming calls received information on loss damage of accidents, DMV, Banks, Dealerships Insurance and Clients and Maintain Excel Spreadsheets on Electronic Lien Title and Paper Title.

Subprime Auto Finance Industry, Title registrations issue and Audit vehicle title for Accuracy legibility.

Request for demands, Review reports on a monthly basis and coordinating title release and entered in appropriate database.

Received, review and process all DMV Title transfer and ELT Sent ELT to Banks along with reports.

Communicate with dealership and DMV to resolve issues with outstanding titles.

Referral Care Coordinator 11/2019 to 06/2020

All’s Well Staffing Agency Huntington Beach, CA

Assist with referral calls in reference to patient referrals.

Attach faxed provider notes to existing or pending referral.

Direct appropriate tasks to fellow care coordinators.

Assist with referral authorization, Denial Letters, Grievance Letters, Appeals Letter.

Data Entry, Issue and responds to Patient, Doctors Calls, Redirect referral.

Expedite Referral, Change CPT Codes, Check for Eligibility, Provider Search, Request for diagnosis. code to be change, Change of Facility, New Authorizations and DME Medical Supplies.

Patient Service Representative 07/2019 to 11/2019

Change HealthCare Thousand Oaks, CA

• Obtains current patient information from established and new patient, accurately enter updates information in scheduling system, Identifies HIPAA, verifies insurance eligibility and assists patient with completion of paperwork when necessary.

• Review's scheduling system for needed updated demographics and consent forms, Schedules and reschedules appointments as needed and creates new account if new patient is not in system.

• Accurately message or transfers call to physicians and nurses when protocol indicated and accurately imports registration documents into patient electronic health records.

• High volume calls : inbound and out bound.

Referral Specialist 09/2018 to 02/2019

Sierra Vista Family Medical Clinic Simi Valley, CA

• Request prior authorization from insurance companies, schedule diagnostic procedures and appointments as appropriate.

• Receive requests from five referring physician's via telephone, fax EHR, referral cases to initial clinical review when appropriate.

• Provide information to referring physician's offices regarding covered benefits.

• Notify patients of covered benefits & schedule appointment.

• Receive verification requests from rendering providers; verify registration information and scan verification into database.

• Receive and handle general information request via telephone and facsimile from various external sources. Initiates, maintains, and updates tracking systems for incoming and outgoing referred referral.

• Participate in utilization management and quality management programs as directed.

• Comply and keep current with accreditation standards and federal, state and local regulatory requirements and perform other assignment as assigned.

Treasury Analyst 02/2017 to 04/2017

Robert Half Staffing Agency Calabasas, CA

• Processed high volume credit card chargeback disputes with tight deadlines.

• Assisted treasury team in various projects including matching bank deposit over/ short.

• Pulling paid checks copies from bank portal.

Healthcare Administrator Coordinator 10/2015 to 02/16 & 05/2016 to 9/2016

Ultimate Staffing Agency Oxnard, CA

• Provide clerical support to Nurse Manager, including auditing SUB ACUTE, ER, and ICU logs, filing, screen calls.

• Payroll reports, Charge Nurse daily report, welcome / Discharge packages, collecting data, Schedules Staff members.

• Time and attendance monitoring, Updated and maintains departmental records and report, organizes departmental files, print and distribute reports.

• Compile Medical records packet for nursing unit, Performs related duties as requested by Manager, Performs advanced computer skills including patient care delivery system.

• Demonstrates knowledge of standard medical terminology and the correct application of terms, maintains a working knowledge of fire, safety and disaster manual, good judgment in tactfully handling difficult situations and responding appropriately.

• Maintains office area neat, clean and in operational manner, Orders and maintains supplies for all office and departments

• Welcoming and assists patients, family members and other visitors with information regarding department services.

• Serves as a liaison between hospital departments, personnel, physician offices and assists with problem resolution and coordinates and organizes the secretarial and utilization management functions of the department and maintain confidentiality in regards to physicians and patient population.

Cal Mediconnect Outreach Coordinator 02/2015 to 05/2015

Regal Medical Group Northridge, CA

• Coordinated daily schedules for Outreach Advocates for individual in-home and community meetings.

• Ensuring all relevant parties are informed and kept abreast of schedule awareness.

• Adheres to established work schedules and practices efficient time management to meet quality service goals and support department objectives.

• Compiled collateral to support Outreach Advocate meetings consistently demonstrate strong organizational skills; able to handle many concurrent projects prioritizing ongoing and ad HOC request

• Creates spreadsheets profiles of members participating in Outreach meetings from various sources including QHMO and other patient information system.

• Assisted field staff in troubleshooting member issues and facilitating timely hand offs to other areas including case management, pharmacy, social work, claims etc.

• Compiled tracking information for data reporting confirming appointments for Advocates and member meeting locations, Inventories and distributes cell phones to Outreach Advocates for member use.

• Effectively navigated through multiple platforms or applications to efficiently locate information and complete required task.

Marketing Assistant Production 12/2013 to 08/2014

Aerotek Staffing Agency Woodland Hills, CA

• Responsible for the research and documentations of variable charts, Returned Mail Cost, Analysis Project Program to Marketing Manager, Marketing Production Manager to ensure smooth workflow from project concept to complete.

• Monitors inventory spreadsheets and information of day -to-day operational aspect of project, scope and deadlines and keeps project team well informed of all changes as it relates to their project.

• Developed and published a monthly project schedules to report results to Marketing In-house Creative, Production, Communications, Vendors teams to ensure clarity of goals and quality and adherence to deadlines with V-Lookups, Formulas and Pivot Tables, Access, Outlook, Visio.

• Coordinates proper projects request intake data and information from Vendors, Analysis inventory of variable charts and providing detailed monthly reports, updates to senior management.

• Act as primary point of contact/liaison between vendors and Program Management, Marketing Operations and Production Team and process purchase order and release of purchase, delivered, Estimate, Breakdown and Magazine specs.

• Managed projects for multiple internal groups to ensure clarity of goals and quality and adherence to deadlines.

• Troubleshoots projects prior to submission to ensure efficiency and time management and properly delegate projects to team member's based on current workload to ensure that all project are properly staffed and executed.

• Reviews brief and request details with Marketing Services team to ensure that all elements and deadlines are understood during regular schedule status meetings.

Education and Training

Grant High School Van Nuys, CA

High School Diploma 1992

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