Customer Service

Francisco Velez Jr.

*** ****** ***** **., *** ***B • Carol Stream, Il 60188 • 815-***-**** • *******@*****.***

Objective

An intuitive, high-energy, solutions-focused health care professional with over ten years of experience working in service oriented environments, and enhancing the provision of quality care. Possess a versatile background implementing highly effective operational solutions within different health care environments. Possess the ability to work in unison and effectively communicate with peers and senior management. Seeking a position to utilize these skills to strengthen and create well managed and quality focused professional health care focused environments.

Work Experience

Quality Inspector

O & K American Corporation, Chicago, Il

09/2016 - Present

Completed critical inspections of products using various quality instrumentation methodologies.

Completed recalibration of micrometers for the entire corporate personnel.

Performed data entry of production data and created production reports for upper management.

Key member of the safety and emergency response teams.

Provided team training and mentoring on all machinery.

Conducted spectrometer analysis of products.

Financial Aid Advisor

Career Education Corporation, Schaumburg, Il

05/2013 - 06/2015

Work closely with Admission Representatives to facilitate outstanding customer service to prospective students.

Work closely with future, active, transfer and re-entry students to evaluate financial aid options.

Develop financial aid plans that meet the student's needs and Federal regulations.

Maintain complete and accurate files to ensure 100% verification and compliance.

Access reports to maintain and track correct disbursements and funding.

Maintain over a 75% average completed student file every month.

Developed close professional relationships with trust and respect among all departments.

Developed excel spreadsheets and PDF versions of many forms used by FAC's.

Maintain students eligible for Federal Aid and ensure proper funding.

Eligibility Patient Advocacy Liaison Services (Team Lead)

NCO Group Incorporated, Milwaukee, WI

08/2010 - 05/2013

Educate patients and patient representatives on the eligibility requirements, application process, and verification requirements for applicable programs.

Ensure accounts are processed in accordance to Eligibility Program standards, Client expectations, and federal and state regulations including but not limited to, Health Insurance Portability and Accountability Act (HIPAA) guidelines.

Provide feedback to management concerning possible problems or areas of improvement.

Facilitate the application process when appropriate for the patient by assisting the patient in the completing of the application, scheduling appointment interviews and obtaining required verification.

Maintain consistent proactive communication with the patient and/ or patient representative throughout the eligibility process, keeping the patient informed of the accounts progress.

Maintain a professional relationship with the patient and governmental agencies to ensure cooperation and compliance.

Document pertinent patient information and all work activity in the appropriate systems dictated by NCO policies and procedures.

Knowledge, understanding, and compliance with all applicable Federal, State, and Local laws and regulations.

Knowledge, understanding, and compliance with NCO policies and procedures.

Maintain knowledge of functional area and company policies and procedures.

Make recommendations to implement improved processes.

Maintain the appropriate level of work activity according to work standards and establish work processes to ensure timely certification.

Train and interview potential employees. Conduct and initiate proper training protocol procedures for new employees.

Monitor employees to ensure that NCO policies are being implemented as well as evaluate employee's productivity.

Patient Accounts Representative

Aurora Healthcare, Milwaukee, WI

06/2006 - 09/2007

Analyzed, prepared, and followed up on insurance claims to include private insurance, Medicare, or Medicaid.

Performed a variety of specialized clerical tasks involved in obtaining patient financial pre-certification and authorizations for health care services and procedures.

Organized inpatient and outpatient claims for electronic or hard-copy mail and forwarded them to appropriate third party payers.

Reviewed claims to make sure that payer-specific billing requirements are met, followed up on billing, determined and applied appropriate adjustments, answered inquiries, and updated accounts as necessary.

Provided financial counseling to patients and their families regarding charges for health care services.

Determined fees for services provided and implemented appropriate collection and refund actions.

Assisted financially responsible persons in arranging payment schedules.

Determined necessity of third party sponsorship and processed patients accordingly.

Examined insurance policies and other third party sponsor materials for sources of payment.

Maintained records of patients' accounts and corrected, updated, and consolidated records to include the application of proper discounts to patients.

Multi-Task Clerk (Team Lead)

Norwegian American Hospital, Chicago, Il

03/1998 - 10/2005

Greeted, assisted, and directed patients. Collected information from incoming patients regarding services needed, insurance available or financial status.

Performed registration, admission, pre-admission, reception, and discharge functions for all patients receiving services in the Healthcare system.

Obtained complete and accurate patient demographic information.

Assisted in completion of admissions or insurance forms, collected co-payments and deductibles from patients and handled daily cash management.

Contacted insurance providers such as Blue Cross Blue Shield, Aetna, etc. to verify coverage and obtain authorization for service.

Served as liaison between patients and staff.

Responsible for scheduling MIR and SDC services.

Originate pre-existing charts, utilized Meditech for data management and ECARE for billing.

Entered charges for Neonatal, Diagnosis (ICD/9), Procedure codes and reviewed claims or records in order to ensure accurate completion or coding in an effort to reduce reimbursement denials.

Very familiar with standard concepts, practices, and procedures within medical billing and coding.

Adhered with all State and Federal regulations such as EMTALA and HIPPA requirements.

Trained and educated new employee's within a health care environment.

Required on call duties for designated shifts for the Outpatient Department.

Education

Colorado Technical University Milwaukee, WI

A.S.B.A. in Medical Coding and Billing, GPA: 2.85

2007 - 2008

Associate of Science Degree in Business Administration (Majored in Medical Billing & Coding).

Colorado Techinical University Milwaukee, WI

B.A. in Healthcare Management, GPA: 3.00

2009 - 2011

Bachelors of Science Degree in Business Administration Candidate (Majored in

Healthcare Management).

Colorado Technical University Milwaukee, WI

M.B.A. in Executive Master of Business Administration, GPA: 3.26

2011 - 2013

Executive Master of Business Administration.

Skills

Extensive leadership and hands-on experience; Bilingual: English/Spanish

More than ten years of experience: Healthcare Administration, Quality Control, Customer Service, and in Admissions and Registration. Profound knowledge of healthcare regulatory compliance such as JCAHO, ACR, COLA.

Operating Systems: Windows NT/2000/XP/Vista/7, Microsoft Server 2000 - 2008, Linux, and MAC OS.

Proficient in the various software: MS Access, Visio, Documentum Document Management System, MS Project, MS SharePoint, MS Word, Excel, PowerPoint, WordPerfect, MS Outlook Email, MS Money, NetMeeting, LiveMeeting, Quicken, Citrix User Client, Symantec Antivirus, Kronos Time System, Novell GroupWise Email, Lotus Notes Email, NSLDS, COD, SSS.GOV, FACS, S.T.A.R., BCARB, Meditech, DataMax, 3M, Allegra, Logicare, Midas, Carenet, SDK, FACS, Advantage and Cerner Care Connection.

Proficient with: VPN Token, Healthcare Data Management Software, Content Management Systems, Process Analysis, Streamline Administration, Reducing costs and enhancing patient Safety and Satisfaction.

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