ad09g0@r.postjobfree.com 480-***-**** Mesa, AZ ***03

PROFESSIONAL SUMMARY

Dedicated administrative professional well-versed in communication, medical terminology and team building. Trained in scheduling, patient medical records, updating and insurance processes. Reliably completes accurate work and goes above and beyond to meet daily demands. WORK HISTORY

Banner Health Corporate Remote. Mesa, AZ

Senior ROI Specialist 10/2019 - Current

Sharecare. Mesa, AZ

ROI Specialist 07/2018 - 09/2019

SKILLS

EDUCATION

Everest College

Mesa, AZ

Certificate: Medical Billing And

Coding

Apollo College

Mesa, AZ

Certificate: Medical Assistant

Validate requests/authorizations for release of medical information according to established procedures.

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Safeguard - protect patient's right to privacy by ensuring that only authorized individuals have access to patient's medical information.

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● Process/released information requests in timely manner. Communicate with patients in professional manner to guarantee them quality service

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Communicate with attorneys, insurance companies, hospitals, police departments, medical examiners, child and adult protective services to release records.

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● Respond to internal email inquiries regarding medical record reviews. HIPAA: Identified potential areas of compliance vulnerability and risk to develop and implement corrective action plans.

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Maintained accuracy, completeness and security for medical records and health information.

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Perform quality checks on all work to assure accuracy of release, confidentiality, and proper invoicing

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Compiled, abstracted and coded patient data using classification manuals and standard systems.

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Communicated effectively with staff, patients and insurance companies by email and telephone.

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● Ensure that HIPAA regulations are met at all times Retrieval of medical records for subpoenas, attorneys, insurance companies, and patients.

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Maintained accuracy, completeness and security for medical records and health information.

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● Input data into computer programs and filing systems. Followed exact procedures for handling transfers and other releases of medical records in timely manner.

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● Ensured smooth admission/discharge process.

● Strong Microsoft Office 2021

Medical Terminology

Understanding

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● Meditech Software

● Citrix Workspace

● Legacy Meditech

● ChartMaxx

Epic Billing & Collections

Procedures

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GMED Software Insurance &

Collections Procedures

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Centricity Software ICD-9

Coding

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● EzCap CPT Coding

Business Solutions HCPCS

Coding

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● VAT Resourceful & Reliable

● Case CATalyst Software

● Attention to detail

● Multitasker

● Typing 60 wpm

Claims Processing Medical

Invoicing

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● Cerner Data Entry

● MRO Efficient

● EPIC EMR

● Customer Experience

Office Health Records

Preparation

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Patient Medical Records

Maintenance, Coding

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● Patient Flow Coordination

Maria E. Munoz

Concentrix. Mesa, AZ

Medical Claims Processor 04/2018 - 07/2018

Arizona Priority Care. Chandler, AZ

Insurance/Medical Claims Records Processor 11/2017 - 02/2018 Southeast Valley Gastroenterology. Chandler, AZ

Medical Records Clerk 04/2011 - 03/2013

● Ensure accuracy and privacy of patient's information Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.

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● Managed large volume of medical claims on daily basis. Paid or denied medical claims based upon established claims processing criteria and coding.

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● Respond to internal email inquiries regarding medical record reviews.

● Responded to correspondence from insurance companies. Used administrative guidelines as resource or to answer questions when processing medical claims.

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● Entered paper medical claims into EZ-Cap claims processing system.

● Sort/distribute all documents faxed to claims department. Analyzed incoming medical records, related claims to determine why records were received, route to appropriate departments for review, and document/track all review stages.

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Communicated effectively with staff members of operations, finance and clinical departments.

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Process medical claims when utilization review denies services and forward all other claims to examiners to process

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Work closely with call center reps and claims examiners to resolve claims processing issues/inquiries.

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Worked with claims adjusters and examiners to expedite processing in alignment with procedures.

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● Evaluated and settled complex insurance claims in strict timeframes. Uploaded physician progress notes, history and physicals into electronic medical records.

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● Completed tasks to maintain office flow

Inbound and outbound customer service calling, for medical record release.

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● Assisted patients with filling out their paperwork in office.

● Translated for some of physicians with Spanish speaking patients. Processed medical records requests from outside providers according to facility, state and federal law.

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● Reviewed charts and flagged incomplete or inaccurate information. Maintained patient confidence by keeping patient records information confidential.

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