Customer Service Insurance

Virginia Montes de Oca

**** *** *** **** # * Torrance, CA 90503

Cell: 310-***-****: ****@*****.***

Professional Summary

Obtain a secure position that will lead to a lasting working relationship in the field of QA Coordinator or Admitting Supervisor. 8 year

highly resourceful QA Coordinator with an impressing record of achievements and strong drive to success: Goal oriented and Results

driven.

Core Qualifications

Demonstrated ability to interact effectively with senior management, proven leadership abilities

Broad research and consulting background

Quick learner, Issue Resolution, computer proficient, extremely organized, file/records maintenance, & data management

Proficient in Microsoft Office Suite: Word, Excel, Access, PowerPoint, Outlook Express

Reports generation and analysis, contract auditing, & process implementation

Experience

QA Coordinator Conifer Health (Tenet) - Anaheim, CA

April 2008 to Current

Weekly & bi-weekly reports, work with management on training & process improvement opportunities, schedule calls, customer service,

monitoring calls, analyze data and draw accurate conclusions as to strengths and weaknesses of operations, create job aids for staff.

Provided onsite training. Developed new process for employee evaluation which resulted in marked performance improvements.

Monitored multiple databases to keep track of all company inventory. Worked directly with department’s managers and Directors to

achieve result. Researched and updated all required materials needed for directors and ASDs. Program's used ACE, VI, Meditek,

Passport, RevRunner and PBAR. Analyst with SQL, currently in process of obtaining Six Sigma Certificate.

Per Diem (ER) Little Company of Mary - Torrance, CA

September 2007 to May 2010

Registering patients, 10 key by touch, heavy computer usage, heavy phone usage, customer service, Work Comp, knowledge of PPO,

HMO, POS, Medicare, Medi-cal, 45 wpm/insurance verifying, financial counseling, program's used passport, Meditek

Lead (SR) Quality Control Century City Doctors Hospital - Century City, CA

June 2005 to March 2008

Audit accounts, daily reports, calling for pre cert., heavy phone usage, heavy computer usage, 10 key by touch, knowledge of PPO,

HMO, POS, Medicare, Medi-cal, customer service, 45 wpm, Bilingual (Spanish), Work Comp, Occupational Health, pre admitting

accounts, registering patients, financial counseling, insurance verifying, pre admitting outpatients, radiology scheduling, activating

accounts & knowledge of TARs. Provided onsite training. Developed new process for employee evaluation which resulted in marked

performance improvements. Monitored multiple databases to keep track of all company inventory. Worked directly with departments,

management to achieve result. Researched and updated all required materials needed for directors and ASDs. Program’s used Med

Series 4, passport, Mutual of Omaha, Medi-cal, HDX, filing of liens, third party billing & billing patients.

Admitting Representative Centinela Freeman Hospital - Los Angeles, CA

January 2003 to May 2005

Registering patients, 10 key by touch, heavy computer usage, heavy phone usage, customer service, Work Comp, knowledge of PPO,

HMO, POS, Medicare, Medi-cal, 45 wpm/insurance verifying, financial counseling, insurance verifying, breakdown charts, Occupational

Health, pre admitting accounts, trained 10 employees, program's used invision (SMS), passport, CWF, and HDX.

Recovery & Savings Analyst Aetna - Los Angeles, CA

October 2000 to December 2002

Provider maintenance, heavy phone usage, filing, 10 key by touch, daily reports, security clearance, data entry, heavy computer usage,

auditing claims, finalizing claims, insurance verifying, initial letters, create reports, daily reports, 45 wpm, collecting on refunds, trained

10 employees, knowledge of PPO, POS, HMO, Medicare, Medi-cal, HCFA, UB-92, EOB, COB, medical terminology, system used

Rumba. Successfully led key projects which resulted in a $2million reimbursement.

Customer Service Supervisor TVN Entertainment - Burbank, CA

February 1998 to October 2000

Supervised 35 employees, handling customers inquires, orders, scheduling, heavy computer usage, heavy phone usage, 10 key by touch,

filing, building accounts, adjusting accounts, billing & charging accounts, training, monitoring calls. Implemented marketing strategies

which resulted in 12% growth of customer base. Provided onsite training. Developed new process for employee evaluation which

resulted in marked performance improvements. Monitored multiple databases to keep track of all company inventory.

Education

El Camino College, 12/94

Redondo Beach, CA

Business & Computers

Glendale Career College, 01/99

Glendale, CA

Massage Therapy, Certified

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