Customer Service Insurance

Norma Gomez

**** ******* *** Houston, Texas* ****7 * (C) 713-***-**** * (E) ********@****.***

Self-motivated, organized, energetic, dependable, ability to learn quickly, contributor with committed to excellence and success seeking a position in a professional environment offering the opportunity to utilize and enhance my knowledge, experience and skills. SKILLS:

Bilingual -English/Spanish

Type 45-50 wpm

Word perfect

Microsoft Word

Microsoft Excel

Internet

10 touch key

Magnum Management

AS-400

Lotus 123

Gateway

TMHP

Medical Terminology

Procedural Coding

Mysis Software Program

Epic Software Program

NexGen

Kronos

ICD-9

CPT-Coding

HCPCS

WORK HISTORY:

Houston Department of Health and Human Services (A-1 Personnel) August 2015-April 2016 Customer Service Rep./Medicaid Billing Specialist

Ensure all claims are accurately billed and paid. Post charges and reconcile accounts receivables. Work charge reviews, claim edits, follow-ups and credit work queues.

Verify accurate coding, Code procedures and diagnosis using current procedure terminology

(CPT), Healthcare common procedure coding system (HCPCS) and International classification of disease (ICD-9) and (ICD-10).

Interpret Center for Medicare and Medicaid Services (CMS) rules and regulations.

Monitor clinical documentation. Bill, collect and process appeals for governmental and commercial payors.

The Methodist Hospital (Burnett Staffing) May 2012-July 2012 Billing Specialist

Reviewed and entered patient demographics as needed in accounts, verified insurance accounts against program provisions and coverage for new and current patients.

Reconcile billing and invoices, check balances, produce statements and maintain patient files by dates and batches.

Posted hospital charges, infectious diseases charges, hepatology charges, hematology charges, pulmonary transplant charges.

Searched and checked to make sure if patients were in-patient, out-patient, selected speciality hospital, skilled nursing facility, reviewed all daily charges and reports for any errors and or errors to be corrected for all batches on a daily basis. Medical Clinic of Houston January 2011-January 2012 Biller I

Reviewed all daily charge forms for completeness and accuracy to perform and work in a fast pace accurate timely manner.

Performed all reports to check for any errors to be corrected before the close of each batch at the end of each day, resolve routine patient billing inquiries and problems.

Posted office charges, hospital charges, oncology charges, rheumatology charges, home healthcare charges.

Prioritize and organize all encounter forms and calculate and balance them on a daily basis, file batch and by date, may perform insurance verification for coverage and eligibility reviewing for new patients and current patient registration.

Texas Childrens Hospital September 2002-May 2010

Charge Entry Clerk III

Received and reviewed charge fee slips ensured charge information is accurate, balance charge fee slips before and after charges for charge summary, billed and entered charges, used ICD-9, CPT, HCPCS, verified insurance coverage and eligibility review new and current patient registration.

Worked under extreme pressure for the closing of end of the month charge entry. Convey claims and invoices for clinic and hospital record keeping, assist sister departments with support as necessary, guarantee accuracy of patient demographic entries, input office and hospital charges into billing system with extreme accuracy in a timely manner.

Balance of charges and all expenditures that are received daily, evaluate return claims and determine reasoning for it, monitor daily insurance reports and distribute claims to appropriate departments, revise billing system with returned mail notices within a suitable period. StarMed Staffing Group October 2001-September 2002 Service Coordinator

Communicating efficiently with employers and employees ensuring the needs of both are met in a timely and effective manner, supported branch manager of the company, recruited new client accounts, completed requested job orders daily for new clients and merchants, scheduled onsite career interviews, produced criminal background checks, all-purpose background checks, and reference checks.

Verified National and Statewide certifications and licensing, organized written and oral testing, accommodated all clientele with job assignments, generated payroll weekly, opened and closed the office daily, audited client documents, directed visitors and callers to appropriate parties, distributed all mail to proper parties.

Assisted in quarterly report processing, heavy data entry, maintained database and files, obtained requested material from files, supported program files and responsible for security of classified documents.

Reviewed resumes and scheduled interviews, scheduled calendars, created new employee information packets, ordered weekly supplies, distributed faxes, mail and copies, assisted with special projects as instructed.

EDUCATION:

San Jacinto Community College

Business Administration (Continuing Education)

Milby High School (GED)

REFRENCES:

Upon Request.

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