Customer Service Insurance

Monique Martinez

Houston, Texas *****

Phone: 713-***-****

Email: ********************@*****.***

Objective: Seeking a position in a professional office environment allowing me the

opportunity to utilize my skills with room for growth and stability.

Skills:

*Administrative and Clerical Duties *Office Assistant

*Medical Assistant *Accounts Receivable/Payable

*Billing and Coding *Office Coordinator

*Account Research Analyst *Collections Specialist

*Claims Specialist *Insurance Specialist

*Charge and Payment Poster *Data Entry Specialist

*Customer Service and Support *Trainer and Advisor

Software:

Computer literate, Internet, Some Excel & Microsoft, Availity, Medisoft, Misys, Medical

Manager, Epic, MD2, etc.

Employment:

04/13 - Present Billing and Coding Specialist

Town & Country Neurology

*Bill and code out daily charges, batching and closing out day.

* Monitor and manage A/R, work delinquent accounts, appeal and dispute denials. Work

all correspondence mail. Submit claims daily, work denials, mail patient statements.

* Submit prescription refills electronically, attach, scan, file, fax to EMR system.

*Insurance verification of eligibility, create and set up patient accounts, provide daily

balances.

*Collections, explain to patient account balances, call carriers for past due balances,

call to collect patient balances by phone.

*Room patients, take vitals, weight, problem, etc transpose into EMR system.

*Answer phones, assist patient with problems, concerns, mediation, authorizations,

setup diagnostic testng, etc.

07/12 - 04/13 Billing and Collections Specialist

Contemporary Medicine Associates

* Billing and coding all inpatient outpatient charges.

* Manage and work A/R daily, monitor and work all delinquent accounts, appeal and

dispute as needed, submit and bill claims on a daily basis and ensure submission within

a timely manner.

*Collections call insurance carriers and patients to collect past due balances on

account.

*Account reconciliation, review and apply payments and adjustments accordingly.

* Assist with phones.

06/08 - 06/12 Stay at home mother

11/07– 06/08 Office Manager

Majdi Taher, M.D. Internal Medicine

* Office administrator/coordinator; handled all office matters, employees, patients and

outside vendors. Setup & enforced office policies & procedures, assured the office ran

smoothly. Handled physician credentialing, setting up new insurance contracts &

renewals, kept up with the physician licenses; made sure reimbursements were

accurate to fee schedule/contract.

* Customer Service; greeted clients and customer, assisted with any matters needed.

* Human Resource; seeked qualified candidates, interviewed & hired, trained,

evaluated & managed 3 employees.

* Accounts payable; paid monthly bills, daily deposits, payments& adjustments posting,

batching, invoicing.

* Biller; billing & coding, data & charge entry, worked with Availity clearing house on

electronic claims submissions & reject errors, also sent out paper claims.

* Collections; disputed & appealed claims, called insurances carriers on delinquent

accounts, sent out collection letters, set payment arrangements as needed.

* Accounts receivable; reconciled & researched accounts, worked correspondence mail

& explanation of benefits, managed a/r daily.

04/05- 11/07 Collection Specialist

George Burnazian, M.D. Internal Medicine/Infectious Disease

* Managed aging report daily, accounts receivable, appealed denials, corrected billing

errors, worked correspondence mail, submission & re-billing claims by paper &

electronic claims submissions, insurance verification.

* Reconciled patient accounts; posted payments & adjustments, provided patients

break-downs for balances owed, sent patients statements, set up payment

arrangements, refund determination.

* Verified & setup accounts for Workers’ Compensation, requested authorizations.

* Medical Assisted when needed; roomed patients, took vitals, documented charts,

gave vaccinations (flu, pneumonia, B12, & shingles). Assisted physician with patient

messages, results, scheduled diagnostic tests, incoming calls, & charting, customer

service.

02/03-04/05Office Assistant

David E. Burns, M.D. Internal Medicine/Rheumatology

* Assisted physician with patient exams, in office procedures; joint aspirations, prepped

supplies & sterilization before & after procedure.

* Sent out claims electronically to Thin clearing house & daily close out three times a

week, maintained a/r, appealed denials, submitted bills & re-billing claims.

* Prepared charts for appointments, filed, documented chart notes (charting), checked

in & out patients, managed front & back office, posted daily charges & payments,

collected co payment & co-ins according to benefits, insurance verification, setup

accounts & charts, entered demographics.

* Assisted pharmacist with prescriptions (new & refill approvals, clarifications &

authorizations).

* Roomed patients, provided lab & diagnostic results to patients for normal & abnormal

findings, answered medical calls & discussed issues with physician provided direct

orders to patients, setup diagnostic tests & per-authorizations.

07/00- 02/03 Patient Account Specialist

Diagnostic Clinic of Houston, PA

* Reconciled accounts, discussed detail billing with patients in a private room & setup

payment arrangements, answered multiple calls incoming in cube.

* Collections, reviewed turn over list before turning accounts over to out-side collection

agency, worked accounts receivable and aging report, called patients on past due

balances for last attempt, negotiated payment arrangements, disputed & appealed all

denied claims, billed & re-billed claims electronically & paper submission through Proxy-

Med clearing house, setup new accounts & demographics, called insurance carriers on

delinquent accounts, post non-payments to accounts, batching.

* Trained new employees on various departments throughout clinic.

* Insurance specialist verified insurance benefits & setup insurance information in

system.

* Worked correspondence mail; eob’s & patient letters, worked denied claims, sent out

appeal letters for reimbursement, sent out patient statements, disputed non-payment

with insurance payers.

04/00– 6/00 Clerical Positions part-time temp assignments (on-call)

The Connection Group, Temp. Agency

* Customer Service, worked front desk, greeted clients, answered and transferred calls,

took messages.

* Data entry, received mail, copied, faxed, filed.

* Ordered inventory/supplies, received and distributed mail into mailboxes, signed off

on mail (ups/fedex).

Education:

Graduate June 2000, Diploma Barbara Jordan High School for Careers Houston, TX

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