Medical Billing Customer Care

Location:

Posted:

February 08, 2018

Juan C López Rodríguez, PMB

ac4eak@r.postjobfree.com

Objective

To obtain a position in a Healthcare Insurance company where I can develop my knowledge in benefits of the company to reach the goals established.

Skills & Abilities

Strongly oriented to claim processing and audit. Appeals and Grievances high performance. Considered organized and very responsible.

Experience

Specialist, Humana, INC

Dates From – 07/09/2017 to Present

Special Project Unit, Responsible for the audit of claims related to Provider Contract Changes, Fee Schedules, etc. Adjustments, collections

Mrs. Jeany Madero, Supervisor. 787-***-****

Specialist, Molina Healthcare of PR

03/09/2015 – 06/30/2017

Appeals and Grievances, Financial Agreements Analyst for facility and provider complaints. Considered as a Lead for the Providers A&G Team

Mrs. Edna Marín, Ops Director 787-***-****

Customer Care Specialist Humana of PR, INC

04/08/2013-11/07/2014

Customer Care to Providers. Authorizations, Payments, benefits, etc. Serve as a Liaison between the providers and all the company

MS. Milagros Mercado, 787-***-****

AFAMEP, Bayamon, PR – Medical Billing Teacher

2012-2014

Medical Billing, Coding and Audit Courses

Hippa Law, Fraud, Waste and Abuse,

Business Development

Education

AFAMEP – Bayamon, PR – Medical Billing and Coding

Medical Billing and Coding Claim Audit, Compliance, etc.

2012.

Interamerican University of PR, Rio Piedras, PR

Aprox 50 credits finished / 1993

Leadership

Past President of PR Lions Club, Dorado Chapter from 2003-2004

References

Available upon request