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Insurance Data Entry

Location:
San Antonio, Texas, United States
Salary:
17.00
Posted:
April 02, 2018

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Resume:

Yari Santiago

***** ** ******** **** **

San Antonio, Texas 78245

Cell: 210-***-****

ac40fn@r.postjobfree.com

Objectives: To obtain a responsible and challenging position to where my education skills and work experience will have valuable application.

Professional Experience:

Event Planner Feb 1999-Present

Planner and organizer of events, from Baby Showers, Weddings, Anniversaries, Luncheons, and Fund Raising. I also prepare small appetizers, assist with the makeup of ladies, attire, and complete set ups.

Christus Santa Rosa Family Health Center Dec 2013-Aug 2017

11130 Christus Hills, Plaza 3, Suite 321, San Antonio, Texas 78251

Medical Records Rep I: Process medical records in a timely matter, by mail, electronic, fax and CD Rom. Verify Resident and Faculty Doctor’s orders and paperwork for processing within 4 different clinics in two different hospitals. Managed special projects as working on merging records to new coc or doctors’ work in boxes. I provide any medical records needed for social security purpose and transfer of care; answer multiple phone lines as well as translate any documentation in Spanish as well as patient information. Maintain policies and procedures up to date; provide doctor credentials as needed. I manage all resolution that came inbound / outbound within clinic and redirect most of the calls and issues as necessary. I am in charge of mail both internal and external, as well all certified mail completion, pick up and deliveries. Coordinate and execute all Clinic Events as well as provide all the information to staff and providers. I Prepare doctor’s audits as well as contacted doctors on status of urgent patient matters. Prepare affidavits of records. Train new hires and doctors prior to graduation for orders, DME, or redirection of documentation in system. Created spreadsheets, Slides and Reports on Excel.

Healthcare Supporting Staff Sep 2012-Nov 2012

8431 Fredericksburg, Suite 340, San Antonio, Texas 78229

Member Connections Rep I: I was a contracted temporarily for Superior Health Plan as a member connections representative and members advocate. I searched for venues where meeting could be held for Superior Health Plan members to share their point of views on how their experience has been with the Health Plan as well as educated patients in different classes from breastfeeding classes to becoming new mothers information. I assisted members and patients with needed information for assistance with utilities, abuse, food, shelter, work, and educational classes, as well as daily living need. I prepared giveaways for classes and volunteer event. I prepped company belonging to move from one location to another. I consolidated information for Inventory such as Literature, giveaways, and information pamphlets.

Humana Inc. May 2008-April 2012

8119 Data Point, San Antonio, Texas 78229

Bilingual Clinical Intake Specialist: Managed Inpatient and Outpatient admissions; processed cases within strict rules and regulations in a timely matter for PR and Outbound Team. I maintained excellent internal and external audits through the use of systems and processes such as CCA, CCP2, CAS, EMPI, PAG, Met Advance, MSR, Mentor, Right fax, and Lotus Notes. Assist as necessary on overtime for both teams and other markets as needed. I worked the Inbound/Outbound entry for all markets like Florida, Orlando, Daytona, Tampa, and Jacksonville; as well as special projects assigned by peers for Data Entry, Met Care, Health Help, and Faxes. Maintained a high production, and provide status of the workload within the teams.

Kinetic Concepts Incorporated (KCI): September 2005 – December 2007

8023 Vantage Dr. Bld. IV, San Antonio, Texas 78230

Claims Specialist II: Verified all insurance and patient information and obtained referrals as well as authorization for patients requiring Durable Medical Equipment, such as The Wound Vac, in order to heal Non-Healing Surgical Wounds. Obtained all doctor documents and required prescriptions with their respective diagnostic codes and wound measurement, and followed up with patient’s progress. Coordinated and processed all documents required for shipping of product and billing of claims; translated documents and information pertaining to referrals and claims from Spanish to English.

Dr. Alan D. Barabeau, M.D. June 2004 – August 2005

7830 Louis Pasteur Dr., San Antonio, Texas 78229

Administrative Assistant / Billing Department: Updated Dr. Credentials, Licenses, Hospital and Insurance, and Provider Information. Processed Claims in Primary, Secondary and Tertiary Insurance, to include Medicare and Medicaid. Verified all insurance information and posted all payments and transactions from insurance and patients. Managed all patients account transactions and submitted all claims to insurance providers, including Medicare and Medicaid, via electronic and regular mail. Worked with THIN, ICD-9, and Coding (procedure and diagnosis codes), and HIPPA regulations. I performed as the clinic Front Desk Supervisor, covering full spectrum of administrative and logistical operations to include receptionist duties, answering phones, scheduling appointments, billing patients’ accounts, prepared charts and ordering office supplies. I assisted with preparation and submission of payment options among insurance providers and financial institutions such as Care Credit, Spectera and Capitol One. As well as translated documentation and verbal communication from English to Spanish as required.

Dr. George Maldonado O.D. October 2002 – March 2004

1702 I-35 North, San Antonio, Texas 78218

Insurance Biller/ Optometrist technician: Billed all insurance claims for Primary and Secondary insurance, Medicare and Medicaid and registered new insurance companies. In addition, conducted filling of patient records and other information, answered phones, ordered contact lenses, managed supply stocks of lenses, instructed patients on proper wear and care, performed computer data entry, performed visual fields and pre testing with patients and translated documentation and verbal communication from English to Spanish as required.

Yari Santiago Dance Studio: February 1999– October 2002

1131 Harry Wurzbach, San Antonio, Texas 78209

Choreographer & Dance Instructor/ Performer: I was a dance Instructor for Latin Music, Bachata, Merengue, Salsa, Cumbia, Guaguanco for Club Arjons, Tabu Lounge, Joes Volcano, Park Place, Sunset Station, The Observatory Nite Club, Broadway Club, The Old San Juan, The Officers Club in Lackland, Hispanic Heritage month for military installations; Ft Sam Houston, including private lessons for weddings, conventions, and special events. I was the owner to the dance studio located on Harry Wurzback open to the public with a performance group Called X-Kalo Frio performing for Fiesta San Antonio and other events in El Paso, Houston, Dallas, San Antonio and Corpus Christi. I performed as the opening act for Paquito Acosta, Grupo Mania, Elvis Crespo, Adalberto Santiago, Water Race Boats in Corpus Christi for The Don Q Team, and San Antonio local bands. I worked on different music videos and represented Miss Puerto Rico in the Pan-American Pageant. I was the backup dancer and dancing group for Charlie Zaa, Paquito Acosta, Stephanie Montiel, Grupo Atrapado and the Arena Boxing Fights in San Antonio

Press Family Dental April 1998 – January 1999

8502 Village Dr., San Antonio, Texas 78217

Insurance Clerk: Prepared, compiled and review all necessary documents for patient clients insurance and account matters. Coordinated benefit Claims for Primary, Secondary, Medicaid and Medicare. Maintained accounts, posted payments, analyzed patient credit and status research, prepared invoice for insurance company billing, and submitted duplicate x-rays required for disbursement.

Education:

San Bernardino Valley College - San Bernardino, California Some Credits

Colton High School - 777 West Valley Blvd., Colton, California 82324

Under name, Sharon Yarira Alemar Santiago. Diploma June 1990

Letters of recommendation and references upon request.



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