Insurance Customer Service

SUMMARY

Quality-focused schedule coordinator committed to approaching administrative tasks with

tenacity and attention to detail

SKILLS

• Medicaid/Medicare guidelines (EOB, denials, appeals, and follow-up)

• Familiar with ICD-9, ICD-10, CMS 1500’s & EOB’s

• Proficient in Microsoft Office (Word, Excel, & Outlook)

• Managed and followed up on 150 denials weekly

• Wrote 100+ appeal letters weekly

• Bilingual English & Spanish

WORK HISTORY

RPC-Reimbursement Specialist 02/2017 to 06/2017

• Conducted insurance follow up

• Read EOB’s

• Able to make appeal letters if necessary

• Filed insurance claims to Medicaid, and other private insurance companies.

• Worked aged receivables

• Identified improper payments

• Billing errors

• Discrepancies on all returned claims through final resolution

• Interacted with patients, and other professionals to establish facts

• Responded appropriately to inquires on insurance claims

• Gathered information required to resolve pending cases CARDIAC CENTER OF TEXAS- SCHEDULING COORDINATOR 10/2016 TO 02/2017 8700 Stacy Rd, McKinney Tx 75070 C:469-***-**** **********@*****.*** GISSELA MACIAS

• Obtained scanned records and uploaded them into the database

• received and processed medical records requests

• adeptly managed a multi-line phone system and pleasantly greeted all patients

• prepared patient charts, pre-admissions, and consent forms as necessary

• Maintained strict patient and physician confidentiality

• Coordinated appointment schedules with all relevant facility department GALLERIA VISION CENTER-RECEPTIONIST/OPTOMETRIC TECHNICIAN 04/2015 TO 10/2016

• Basic clerical duties, answering phones and scheduling appointment

• Obtaining patient history and conducting preliminary testing

• Comprehension of Crystal Practice Management software

• Contact lens inventory managent

• Providing contact lens training to patients

THE CHILDREN’S PLACE-SALES ASSOCIATE 08/2014 TO 04/2015

• Customer service

• Conducting sales transactions

• Cashier balancing

• Stocking and inventory

EDUCATION

EVOLUTION ACADEMY

HIGH SCHOOL DIPLOMA-2012

COLLIN COMMUNITY COLLEGE

ASSOCIATES OF ARTS-CURRENT

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