Insurance Medical

Summary

Skills

Experience

Patricia Garcia

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

Fresno, CA 93705

Cell: 559-***-****

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

Energetic and enthusiastic insurance professional motivated to succeed in a fast-paced and deadline-driven professional environment. Excelling at working with individuals from diverse cultural and socioeconomic backgrounds. Personable and resolution-focused.

Knowledge of HMO's, Medicare and Medi-Cal

Managed care contract knowledge

CPT and HCPCS coding

Claims Appeals procedure

Workers' compensation knowledge

Prioritizing account issues

Claims appeal procedures

Contract negotiation review/drafting

Familiarity with disease management programs

Confident public speaker

Cross-functional team leadership

Managing multiple priorities

Compliance testing knowledge

Reports generation and analysis

Conflict resolution tactics

Vendor/Client Relations

Medical terminology knowledge

MS Word, Excel and Outlook

UB-92 billing forms

Exceptional time management skills

Health insurance processing

Client Service Coordinator, 09/2005 - 01/2018

Delta Health Systems - Stockton, CA

Identified and developed creative solutions for problems. Investigated issues and problems and drafted responses to urgent requests. Dispensed guidance, direction and authorization to carry out major plans. Cultivated strong working relations with other executives, account managers and brokers Represented the company at meetings.

Ensured exceptional client service and quality product offerings. Created professional business presentations.

Initiated and updated yearly renewals agreements and applications. Interpreted and relayed information in a clear format for clients, brokers and members Corresponded daily with clients, insurance adjusters, and members Educated Member's on a monthly basis on Health and Welfare Benefits. Maintained compliance with company and legal requirements. Completed quarterly and yearly reports for clients.. Computed, recorded, and proofread data, records and reports. Reported and consolidated client's financial performance. Calculated, prepared,invoices and account statements according to established procedures. 02/2005 - 09/2005

Dr. Gurdeep S. Ranu, MD - Fresno, CA

Screened telephone calls and inquiries and directed them as appropriate. Processed and tracked medical insurance claims

Cross-trained and provided back-up for other Assistants when needed. Education and Training

Activities and Honors

Support duties for diagnostic and technical treatment procedures, such as setting up and operating special medical equipment and apparatus.

Kept facility stocked with necessary supplies, equipment and instruments. Life and Health License from A.D. Banker & Company HealthCare Interpreter Certification from National Council on Interpreting in Health Care CPR/First-Aid Certification/Training from Sanger Fire Department A.D. Banker & Company Continuing Education Accredited courses America's Health Insurance Plans (AHIP) National Association Toastmasters International Club

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