Customer Service Insurance
Resume:
San Antonio, Texas *****
210-***-**** cell
210-***-**** home
*******@***.***
Cris Carreon
Qualifications
I have extensive knowledge of all aspects of medical insurance and collection as well as staff management in a business office setting in both hospital and doctors office. I am cross trained in billing. I have a working understanding of ICD-9, ICD-10 and CPT4 coding as well as medical terminology for both hospital and non- hospital settings. I am knowledgeable with attorney liens and letters of protection. I am current on rules and regulations for Workers Compensation, Medicare and Medicaid. I regularly attend seminars to keep updated with any changes in state law. I also have knowledge of Military Insurance (Tricare), Department of Labor (ACS), and Department of Defense (DOD). Currently attending nursing school and have advance medical professional CPR and defibrillator trained.
Experience
October 2017- June 2018 Texas Oncology PA San Antonio, Tx
BCBS Oncology Collector
Review accounts for underpayments. Appeal underpaid claims using medical records and any additional information for maximum reimbursement. Audit accounts for accurate ICD 10, HCPS and modifiers. Bill and re-bill corrected claims. Track and communicate trends that can affect payments.
May 2017- September 2017 CGI Federal San Antonio, Tx
Medicare Case Manager
Review claims paid by Medicare to providers for accuracy in paid amount and if reimbursement to Medicare is required. Audit diagnosis codes billed by providers. Audit to verify Medicare was the responsible party. Escalate case after initial appeal by provider for further collection.
2012-2017 Chrisuts Health San Antonio, Tx
Collector/ Biller/ Validator
Collection of outstanding A/R for commercial insurance and Workers Compensation, appeals and insurance payment validations
Cross trained in collections for Medicare, Medicaid, Commercial, WorkComp, Government Insurance and Department of Defense insurance benefits.Assisted in new staff training and current inventory training
2009-2011 HCA-Methodist/St.Davids San Antonio, Tx
Collector/ Government and Non-Government
High dollar collections of both in/out patient accounts.
Medicare manage care collection.
Assist with special collection projects
Appeals and customer service cross trained.
2005–2008 Physicians ASC San Antonio, TX
Collections/Customer service/Work Comp
Collection and customer service per the duties assigned by BOM.
Billing and coding back up cross trained.
Assist with verifications and surgical scheduling.
New staff training.
Registration and pre- admitting.
2004–2005 HCA-Methodist/St.Davids San Antonio, TX
Collector/ Government and Non-Government
High dollar collections of both in/out patient accounts.
Work comp collector and assist with Medicare billing issues.
Special teams in charge of special collection projects.
Appeals and customer service cross trained.
2002–2004 Southwest General Hospital San Antonio, TX
Collections Team lead/Registrations
Assign work duties to multi setting staff for collections/customer service and verifications.
Trouble shoot in 120 plus AR non-collected status.
Patient coordinator for self pay collections.
Appeals and contracting back up.
Registration cross trained in ER and main pre-admit.
2002–2002 University Hospital San Antonio, TX
Collections supervisor
Supervise collection for government and non-government carriers.
Supervise collections for transplant unit and in/out patient accounts.
Appeals and contracting.
Cross train/back up in registration.
2002-2002 Triad-First Contact Houston, TX
Insurance collector- Team Lead
Collections of out of state hospital accounts. (outsourced)
Customer service representative.
Appeals and on-site insurance coordinator.
1999-2002 McAllen Medical Center McAllen, TX
Insurance collector/biller/registration
AR collector for high dollar accounts.
Appeals and contracting issues.
Self pay collections and customer service.
Cross trained in billing for out patient ASC accounts.
Registration back up in ER setting.
Education
1982–1986 McAllen Memorial High School McAllen, Tx
Diploma obtained.
1986-1988 University of Houston Houston,Tx
Non grad 1 year attended.
1989-1990 Professional Business School Houston,Tx
Certificate of Completion in Business/Accounting
2000-2001 South Texas Community College McAllen,Tx
Coding pre-requisite
2003-2004 St.Philip’s College San Antonio, Tx
Certification in Word/Excel/Power point
Interests
I like working with people and sharing my knowledge of insurance and customer service. I am also currently enrolled in Nursing School UTHSC and hope to graduate in the near future. I speak, read and write Spanish fluently and can assist with translation. I am also a Notary Public for the state of Texas.
Reference:
Diana Verastigui Baptist Health System 210-***-****
Yolanda Contreras Christus Health 210-***-****
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