REBECCA ESPINOSA-MORENO

Kansas City, MO *****

ad3hvw@r.postjobfree.com

+1-816-***-****

SKILLS: Billing and Authorization, Customer Relations, Microsoft Office experience. Call Center experience. Problem/Solution Specialist. National Accounts/Patient Relations/ Branch assist. Medical Terminology and Insurance Management. Various Databases relational to Profession i.e. Acis, BPM, Sharepoint, Dependable, Strict adherence to schedules, and reliable transportation. Kinnser, Wellsky,. Willing to relocate: Anywhere

Work Experience

Medical Office Assistant

HCA Healthcare- Aston Carter Temp Service - Overland Park, KS May 2023 to October 2023

Responsibilities include all front office functions, appointment scheduling, telephone duties, patient registration. Insurance verification. Handling medical records, filing, cashiering . ECW appointing. Checking people in max 10 min.. Collecting co-Pays,, entering charges. Payments. Insurance verification, scheduling, canceling, and reschedule pt appointments, greet communicate with patients and providers. Customer Solutions Representative

Quest Diagnostics - Overland Park, KS

March 2022 to May 2023

Provide client Support in the risk assessment Division for Examone portfolio of services including lab, underwriting, imaging and MVR. Handle all customer inquires via phone, email and other electronic communication in a timely matter, research and resolve issues with insurance applicant orders. Act as a direct liaison between insurance companies, brokers use protocols for reporting client issues or concerns, monitor status of applicant cases.

Patient Access Specialist

AssistRx - Overland Park, KS

October 2021 to March 2022

Supported the Financial Assistance Dept during reapplication season. Handled patient and payor correspondence for three programs in office while conducting outbound calls for missing information. Provided general information about different parts of the FA application, prior authorizations and pharmacy changes. Abided by all regulatory requirements for important Safety Information . (ISI) Patient Information (PI) Adverse Events/ product Quality Complaints (AE/PQC) reporting. Client Service Representative

Quest Diagnostics - Lenexa, KS

July 2017 to April 2021

Place outbound calls to clients, reporting laboratory results using established protocols and accordance with call log policies. Document call history in required format and maintain complete and accurate records. Contact Client to resolve routine matters related to patient tests and results. Escalates issues as appropriate. Handle all Client inquires received on the telephone regarding patient results, inquires of tests and services.

Benefits Coordinator- United Health Group

Randstad/Axelacare Health Solutions - Overland Park, KS December 2016 to February 2017

Responsible for intake patient referrals, insurance benefits verification and coordination of new admissions with nursing and pharmacy staff. Data Entry of patient demographic information, medical information therapy information, and insurance.

Coordinate and verify major medical and pharmacy benefits with all payer types, Medicare, Medicaid, and Commercial payers.

Obtain authorization of services rendered as required by payer. Re verify patient eligibility, monitor insurance caps and prior authorization periods, demonstrate interpersonal skills among coworkers. Answer incoming calls and triage to appropriate personnel. Patient Service Representative

Aerotek/Triwest - Kansas City, MO

July 2016 to November 2016

Places outbound phone calls to beneficiaries and providers as needed within contractual timelines. Contacts civilian providers regarding appointment vacancies on behalf of the beneficiary. Makes appointments for beneficiaries using the CHCS/Appointing module for primary and specialty care in accordance with the VA appointing guidelines.

Consistently displays professional and courteous service skills to internal and external customers. Responds to inquires from beneficiaries and providers regarding specific aspects of the VA program. Information and assistance includes referrals, authorizations and the location and use of network. And certified providers.

Takes steps to develop proficiency for tracking and updating consult report status. Comply with HIPPA regulations to protect privacy of the beneficiaries health information. Documents medical referrals to the facility of the network provider in line with procedures. Documents communication between providers and beneficiary. Interfacing with other departments. Develops knowledge of various software applications. Assesses faxed documents to ensure appropriate entry into the medical management system. Works with standard coding system. Including medical taxonomy, international classification for disease, current terminology and Health Care Common Procedure Coding System. Processes authorizations requests and referral requests in the online medical management system. Keys enter data information into the medical management system. Authorization/Suspended Billing Representative/ Customer Service Apria Healthcare - Overland Park Kansas

November 2011 to July 2016

Performs timely follow up on renewal authorizations to maintain reimbursement activity. Contacts patient to gain involvement in problematic situations.

Performs follow up on outstanding CMNS CERTIFICATE OF MEDICAL NECESSITY prescriptions and processes renewal CMN’s. Researches diagnosis and insurance benefits to receive proper reimbursement. Assist in obtaining authorization for reimbursement. Request adjustments on accounts. Maintain and monitors follow up system to confirm action to take place. Evaluate all completed CMN’S/ Authorizations to ensure that the appropriate information has been obtained. Enters CMN’s/ RX’s information into the computer once the RX’s are completed and returned by the physician. Documents all account information into the system. Processes, reviews and mails RX’s and CMN’s to Physicians for signatures.

Pharmacy Technician and Accounts Receivable Clerk

Aetna RX Home Delivery - Kansas City, MO

January 2004 to February 2010

Research and solve problem cases

Contact customers to resolve discrepancies and disputes. Explore the reasons behind the rejected credit card and resolve to obtain payments. Release Of Information Clerk

Providence Medical Center-Chart One –Contract - Kansas City, KS January 2003 to January 2004

Open daily mail, date stamp, log information, send out letters for payment of medical records. Receptionist front office. HIPPA Regulation

Unit Secretary-Emergency Room

Saint Lukes Northland Hospital - Kansas City, MO

January 2003 to December 2003

Customer Service (Patient and Staff)

Fax records and broke down charts.

Admissions into the hospital. Contacted Physicians for the ER Physicians. Health Information Management-Medical Records Clerk Baptist Medical Center - Kansas City, MO

January 2003 to December 2003

Responsible for release of medical records in accordance with HIPPA Laws. Responsible for management of medical records.

Front desk duties, including multi-line phones, faxes, processing medical staff requests. Routine contact with Physicians, hospital staff and patient care units. Assist medical staff in record completion.

Computer Applications: Microsoft Suite, Windows, ACIS, Patient Pay Management Software, Skype, Optimax, QLS, avaya phone

Education

Medical Office Management

Concorde Career Institute

Northeast Law Magnet High School

Skills

• SKILLS: Billing and Authorization, Customer Relations, Microsoft Office experience. Call Center

• Pharmacy Technician Experience

• Microsoft SharePoint

• Medical Terminology

• Multi-line Phone Systems

• Medical Office Experience

• eClinicalWorks

• Medical Records

• EMR Systems

• Medical Scheduling

Certifications and Licenses

Pharmacy Technician License

Assessments

Protecting patient privacy — Proficient

March 2022

Understanding privacy rules and regulations associated with patient records Full results: Proficient

Protecting patient privacy — Proficient

August 2023

Understanding privacy rules and regulations associated with patient records Full results: Proficient

Protecting patient privacy — Proficient

August 2023

Understanding privacy rules and regulations associated with patient records Full results: Proficient

Customer focus & orientation — Completed

September 2023

Responding to customer situations with sensitivity Full results: Completed

Medical billing — Proficient

August 2023

Understanding the procedures and forms used for medical billing Full results: Proficient

Work style: Reliability — Proficient

August 2021

Tendency to be reliable, dependable, and act with integrity at work Full results: Proficient

Medical terminology — Completed

September 2023

Understanding and using medical terminology

Full results: Completed

Work motivation — Proficient

August 2023

Level of motivation and discipline applied toward work Full results: Proficient

Medical receptionist skills — Proficient

August 2023

Managing physician schedules and maintaining accurate patient records Full results: Proficient

Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.

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