Customer Service/Billing/Claim Follow Up
Resume:
Cynthia Cruz
***** *. ***** ****** ******* #****
Phoenix, AZ 85053
Email: *******.*******@*******.***
Phone number: 602-***-****
Accomplished professional, with diverse background in customer service and the healthcare industry. Seeking an opportunity with a growing company to enhance my experience and qualifications to contribute to the goals and objectives of a company’s services. Self-motivated, able to work both independently and as a team member along with the ability to multi-task. Professional Experience:
Caid Solutions, Arizona (company sold to EnableComp)– Appeals Coordinator
-Perform medical insurance follow-up with Medicaid Agencies in the US.
-Handled denials and submitted appeals.
-Obtain hospital retro-authorizations and physician referrals to overturn denials.
-Submit electronic or hard copy claim to appropriate Medicaid Agency. InHouse Techies Inc, Arizona – Office Manager
-Responsible for incoming Customer support calls and create an open service ticket for issue to be resolved by IT Division.
-Assisted clients with password reset, create new email accounts, placed cell phone orders with accessories, ordered computer parts.
-Coordinated all technician appointments.
-Handled Accounts Receivables and Accounts Payables via QuickBooks.
-Created and mailed client Invoices.
NBA, LLC, Arizona (company sold to Cardon Healthcare) – Lead Medical Biller
-Responsible for training and auditing of new hires in the Billing Department in all aspects of insurance verification, prior authorizations, physician referrals, paper and electronic billing.
-Perform quality audits for all Billers.
-Responsible for claim closures.
-Extensive knowledge of every Medicaid Agency and their contracted agencies.
-Extensive use of Emdeon solution, Medifax, for insurance eligibility status. Sun Radiology, Arizona – Billing and Authorization Specialist
-Verified insurance benefits and obtained authorization for services for diagnostic services such as MRI, CT, PET, Nuclear Medicine, Mammograms.
-Posted charges and submitted claims to insurance companies
-Perform medical insurance follow-up.
-Processed denials and appeals.
-Scheduled patient appointments.
NBA, LLC, Arizona – Medical Biller
-Submit claim electronic or hard copy to appropriate Medicaid Agency.
-Obtain hospital retro-authorizations and physician referrals.
-Perform medical insurance follow-up with Medicaid Agencies in the US.
-Handled denials and submitted appeals.
-Extensive use of Emdeon solution, Medifax, for insurance eligibility status. NHI Billing Services, Arizona – Medical Claims Follow-Up
-Perform medical insurance follow-up with Medicaid Agencies in the US.
-Submit claim electronic or hard copy to appropriate Medicaid Agency.
-Obtain hospital retro-authorizations and physician referrals.
-Submitted appeals.
-Extensive use of Emdeon solution, Medifax, for insurance eligibility status. Hartford Insurance, Arizona – Med Pay Claims Processor
-Review medical bills for valid treatment as a result of auto accident.
-Approve payment of medical bills related to auto accident.
-Back-up Receptionist for Customer Service Department. NHI Billing Services, Arizona – Receptionist/Billing Department Support
-Receptionist on multi-line phone system handling calls from healthcare providers and Medicaid Agencies.
-Process and distribute daily mail.
-Responsible for data entry of healthcare claims and maintained high quality standards.
-Obtain hospital retro-authorizations and physician referrals.
-Extensive use of Emdeon solution, Medifax, for insurance eligibility status. Education:
Centennial High School, graduated May 1998.
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