Medical Insurance

Customer and Personal Service Bilingual - Ability to speak, write

fluently in Spanish and English

Knowledge of managed care

industry and medical coding:

EOB'S, CPT Codes, ICD10, DRG,

UB04, CMS 1500,

Assisted in training mentoring,

and strong ability to coach,

counsel, and motivate

performance.

Abi l ity to prioritize dai ly work

with minimal supervision.

Serve as liaison to providers (

including physicians, hospitals,

ancillary providers and internal

departments)

Proficiency with Microsoft

applications, IDX billing, EPIC

systems.

Strong telephone customer

services ski l ls.

Service oriented and able to

identifying problems and resolve

them.

Mar 2016-Jun 2016

Aug 2014-Dec 2014

Jan 1994-Aug 2013

JUAN CARLOS BURGOS

Professional Summary

Friendly and enthusiastic Patient Access Specialist 20 years of experience in health care . Able to learn new tasks quickly and proficient in growing complex insurance industry's.

Skills

Experience

Medical billing

MD Anderson Cancer Center - Houston, TX

Answer telephones and direct calls to appropriate staff. Veri fy Medicare el igibi l i ty

Load into EPIC System.

Account Specialist / Temporary Agency Media Staffing Baylor College of Medicine Genetics Department - Houston, TX Use computers for various applications, such as database management or word processing.

Entering insurance information for claim pressing in EPIC billing system. Collect and deposit money into accounts, disburse funds from cash accounts to pay bills or invoices, keep records of collections and disbursements, and ensure accounts are balanced.

Patient Access Specialist

15523 Blue Creek Ranch Dr., Houston, TX 77086

Ph: 832-***-****

***********@*****.***

Jun 1981

MD Anderson Cancer Center - Houston, TX

Coordinated communication between patients, family members, medical staff, administrative staff, or regulatory agencies

Demonstrating analytical thinking to pursue referral information not available on initial contact.

Ensuring accurate,concise completion of the registration and financial clearance process.

Acting as a consistent resource and liaison between patients,physicians and faculty to coordinate accurately in ensuring optimal scheduling with all new, returning, admissions, hospital transfers and financial clearance prior to acceptance.

Coordinate communication between patients, family members, medical staff, administrative staff, or regulatory agencies.

Advise admission office of patients acceptance.

Financially clear patients by obtaining referrals and authorizations for outpatient surgeries, inpatient admissions and procedures. Review all incoming request for pre-certification or referral authorization for completeness of information provided.

Ensure that in network providers are utilized. Obtain proper CPT procedure codes, ICD10 diagnosis codes, to determine approval/denial of services. Work with International Department to coordinate the patients scheduling and financial clearance.

Education

High School Diploma

Robert E. Lee High School - Houston, TX

Contact this candidate