Customer Service Medical Assistant
Resume:
Jeannette Maradiaga
San Antonio, Texas 78213
**************@*******.***
OBJECTIVE
Seeking a position that will benefit from my educational and professional training and enables me to make a positive contribution in a team environment
HIGHLIGHTS OF QUALIFICATIONS
* Proficient in multi-tasking and organizational skills
* Extensive experience in relationship management and maintaining
confidentiality.
* Commitment, competent professional able to work well under
pressure.
* Excellent oral and written communication skills, and problem
solving.
EDUCATION
Southern Careers, Medical Assistant
A content rich curriculum plan with emphasis on assisting RN,LVN and Doctors in medical field.
Southern Careers Aug 1999- May 2000
Robert E Lee High school- Diploma-June 1991
General Studies.
PROFESSIONAL HISTORY
RCA(Resource Corp of America)-03/13 to 03/2014 Liens Specialist
* Investigate and verify all details related to a MVA including making sure the patient received medical treatment within the 72 hour required timeframe.
* Initiate and complete the lien process. This includes creating the Notice of Claim of Lien, having the lien notarized, and filing the lien at the county courthouse of the claimant’s hospital and recording the docket number
* Notify appropriate insurance companies and/or attorneys of any lien filed and/or released. This will include sending all interested parties’ copies of the lien filing
* Maintain constant communication with insurance companies, attorneys, adjusters, patients and other interested parties to help ensure maxim reimbursement.
* Ensure any reimbursement payments received correspond to the balances shown.
Web TPA-12/2012 to 03/2013 Customer Service Representative
* Read the claims
* Web enrollment system for accurate benefits
* Calls under 4 mins
* Provide telephonic customer service to participants, providers, plan sponsor representatives and other callers.
CGI Federal-07/2012 to 11/2012 Caseworker
* Involved in the start-up of the MSPRAC project which includes research of MSP Policies and Procedures for the creation of Statement of Procedures. Responsible for managing Medicare insurance leads for improper payments.
* Identify and confirm coordination of benefits. Initiate collections process to employers including evaluation of beneficiary information.
.
Medtronic-10/03/2011 to 04/2012 Accounting Clerk ll
* Responsible for all aspects of billing, credit and collection activities including customer service with an objective of maximizing cash flow and keeping DSO to a minimum.
* Verify accuracy of stamens as well as other healthcare financial accounting records.
* Initiate follow-up activities with third-party payors regarding open claim balances; make written and verbal inquiries to payors for full resolution.
* Analyzes and problem solve account issues to full resolution.
* Resolve accounts by identifying opportunities for payment transfers, refunds, contracting issues, short pays, denials, adjustments, and payment posting issues.
* Identify nonpayment trends, issues, and errors to be escalated to upper management.
* Maintain a quality performance review of 2.85 or higher.
Kinetic Concepts-
Feb 2006- April 1 2011 Patient Finance Specialist II
* Confer with customers by telephone or in person to determine reasons for overdue payments and to review the terms of sales, service, or credit contracts.
* Advise customers of necessary actions and strategies for debt repayment.
* Persuade customers to pay amounts due on credit accounts, damage claims, or non-payable checks, or to return merchandise.
* Sort and file correspondence, and perform miscellaneous clerical duties such as answering correspondence and writing reports.
* Arrange for debt repayment or establish repayment schedules, based on customers' financial situations.
* Negotiate credit extensions when necessary.
* Assist with training new employees, testing new system updates.
* Also help out with team mates with questions when supervisor and lead were away in meetings. Recommended patients for financial help within the company.
* Refile claims and appeals when needed.
* Ran credit cards for payments.
Kinetic Concepts-
Nov 2002- Feb 2006 Insurance Collector l
* Met once a month for payor contract problems with upper management and payors
* Met monthly goals and finish reports.
* Received certificates of reaching goals monthly.
* Example A/R $845,167 collected 121% of A/R
* Monitored reimbursement of all private, manage care carriers, Blues and Managed Medicaid and Medicare.
* Collected on outstanding insurance carriers through a variety of tools including persuasive phone skills and personal customized spreadsheets tailored to monitor and update account status.
* Made proper adjustments on accounts .
* Ensured accuracy of all claims information.
* Responded to customer questions and complaints.
South Texas Pediatrics of San Antonio -Oct 2000 – October 2002 Collections Specialist I
* Identified and pursued delinquent accounts, and secured payment arrangements on private pay accounts.
* Appealed and re-filed claims with appropriate correspondence.
* Had daily interface with customers regarding invoice questions.
* Requested referrals and all necessary documentation in a timely manner to facilitate positive cash flow.
* Monitor and updated accounts receivable and A/R reports for outstanding accounts.
* Posted payments daily from Medicaid.
Kelly Services- May 2000 – Oct 2000
* Worked temporary for a contracting with University Hospital billing medicare claims, ran beginning and end of day reports.
* Helped cleaned up A/R that University was transiting over to new system.
ANCILLARY SKILLS
Proficient in Microsoft Word, Excel, Access, and Outlook. Also have extensive experience with Oracle, Delaire and Centricity, Artiva, OnBase. Strong knowledge of billing software and able to type 35-60 wpm.
Contact this candidate