Customer Service Medical

Health Information Management/Medical Office/Insurance

MICHAEL MARTINEZ

****- * ****** **** ***** Cell: 336-***-****

Winston-Salem, NC 27103 Home: 336-***-****

HEALTH INFORMATION MANAGEMENT PROFILE: CORE COMPETENCIES

Assisting Management in Projects at BlueCross and BlueShield of NC, Health Information Technology and Management at Wake Forest University Baptist Medical Center, and High Production Rates to Close out Long Term Projects in Remarkable Time Limits.

6 years of experience in Patient Relations, Customer Service, and Office Management within a Private office's, a Fortune 500 company, and one of the Nation's Leading Hospital's. Highly dependable, passionate, responsible, and able to achieve results others believed to be impossible. Experience in Health Care, Business Relations, Communication, Team Management and Health Information Management.

Administration

Release of Information

Scheduling and Coordinating

Partner/ Patient Relations

Accounting

Government Medicare/ Medicaid

Analysis and Review

AR/ AP

Health Information Management

PROFESSIONAL EXPERIENCE:

Wake Forest Baptist Medical Center -- Winston- Salem, NC 2012- 2013

Wake Forest Baptist Medical Center is a preeminent, internationally recognized academic medical center of the highest quality with balanced excellence in patient care, research and education. Ranked by U.S. News & World Report as among the nation's best hospitals in seven areas. 34,000 employees. 814 Licensed Beds.

Health Information Management/ ROI Specialist

Successful in Release of Information in Wake Forest Baptist Medical Center's Health Information Management Department as an ROI Specialist with Midwest Medical Records Association of Chicago, Illinois.

Release of Information: Improved My Experience With Medical Information by Assisting Government Agencies, Patients, Attorneys, and Insurance Companies With Release of Medical Information According to HIPPA Compliance Laws.

Compile and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts.

Proficiency in Centricity, AccessAnywhere, Epic, WakeOne, MRView, HealthQuest, CareCast, Citrix, and Click Medical Softwares..

Release information to persons and agencies including Infectious Disease clinics and HIV/AIDS Clinics.

Cardiology Department, Surgery Department, Comprehensive Cancer Research Department, Brenner's Children's Hospital, Hematology and Oncology Department, Radiology/Pathology Department, Emergency Department, Neurology Department, Psychiatric Department, Orthopedic Department, Pediatric Department, Obstetrics and Gynecology Department, Endocrinology Department, and Otolaryngology Department Release of Information and Request Specialist and File Retrieval Specialist.

BlueCross and BlueShield of NC -- Winston- Salem, NC 01/2012- 07/2012

Blue Cross and Blue Shield companies provide healthcare coverage for nearly 100 million people -- one-third of all Americans -- in all 50 states, the District of Columbia and Puerto Rico. Blue Cross and Blue Shield companies represent the full spectrum of healthcare coverage.

Senior Market Administration Claims Representative (Medicare Advantage/Supplement and Coordination of Benefits)

Increased My Knowledge and Skills in HCPS, ICD-9, CPT Codes as well as My Knowledge of Government and Private Insurance.

Medicare Supplement/ Advantage Project-Successful! : Within 3 months, adjusted and corrected Medicare Insurance claims to pay over 500,000 Claims.

Coordination of Benefits Project-Successful! : Reviewed over 20,000 EOB Claims for BCBSNC for Benefits Analysis to close a 2 year project.

Within two months, processed and adjusted over $2 million in unpaid claims.

Increased production and sales rate at 99.75%.

Generated requests for EOB's and Analyzed current EOB information.

Reverse paid claims and issue new payment according to new fee schedule from providers; evaluating, investigating and settling claims.

Transmited claims for payment or further investigation and Applied Medicare Insurance Regulations.

Worked closely with Managers to successfully close out numerous projects within the company and lead a team to high rates of success.

Familiarized Medicare Plans and Benefits System; Familiarized with BCBSNC Plans and Benefits; Adheres to HIPPA policy and Regulations Protocol. Trained to operate Macess Operating System; Amisys Operating System; Pristine Operating System; IPD/Repository Operating System.

Continuous study of EX, ICD-9, HCPCS, and CPT Codes. Quality Check and different Billing Types

DR. Barton Family Practice- Denton, NC 2008-2011

Dr. Barton Family Practice provided urgent care and physician care for over 450 patients in Davidson County.

Office Billing Coordinator/ Medical Assistant

Rapidly gained experience in Health Care and gained acceptance from patients and Doctors with my Caring and Professional Approach.

Office Billing Coordinator : Worked closely with insurance companies to close out patient bills and worked as the office accountant with budgeting the bills and supply costs.

Medical Assistant : Helped the Doctor interview patients as well as obtained vital signs.

Patient Billing and Collections

Account Posting, AR/AP

Obtain and record vital signs, X-Rays, and EKG's.

Found Success in the following Office Skills: Receptionist; Knowledge of multi-line phone systems; Customer Service Call Center; Insurance verification; Auditing Insurance claims and EOB's; Create Word Documents; Collection; Efficient in use of office equipment such as Fax, Copy, Scanning and Credit Card Machines; Microsoft Office and other Computer Programs; Scheduling and Billing; Medication Administration and Accounting.

Monitored office operations and enforced any changes brought to attention.

EDUCATION

Baker College, Flint, MI 2012- Current

Associate of Business in Accounting and Computer Information Systems, Baker College, Enrolled

REFERENCES

Professional Refences upon request

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