Melissa Garcia

**** * ******** *** ************, IN 46226 / 830-***-**** ad3rkh@r.postjobfree.com

Customer service-oriented professional, able to provide administrative support and function as the primary interface between the patient and the provider. Follows policies, procedures, and guidelines to assure consistent quality. Ability to discreetly manage large amounts of sensitive and confidential information.

§Well organized and experienced with Microsoft Office Suite.

§Resourceful, flexible, and adept at acquiring new skills in support of company objectives.

QUALIFICATIONS

Basic coding skills for ICD/CPT Third Party Medicare Medicaid HMO PPO

CMS1500 Claim Form Billing Billing Cycle Claims Appeal Process

Electronic Health Records EHR / EMR Greenway Computer Information Systems

HIPAA Compliance Anatomy & Physiology Meaningful Use ICD-9 ICD-10

Medical Administrative Assistant Medical Terminology Patient Processing Patient Registration

Medical Billing Medical Records Management Release of Information

Medical Laws & Ethics Principles of Management

Medical Transcription Office Accounting MS Office / MS Word Pathophysiology for Medical Office

PROFESSIONAL EXPERIENCE

Centene managed health services. 03/01/2023-current

Call representative advocate/Customer service rep.

Provider/member service inbound calls customer service

Customer support per claims and plan service

Medical terminology as well as health care insurance

Anthem BCBS. 05/15/2021-02/02/2023

Customer service representative

Member service inbound calls customer service

Customer support per claims and plan service

terminology as well as health care insurance

Young America Insurance. 08/27/2018- 04/21/2021

Multi-Manager /Customer service representatives/training.

Training provisional agents for State Licensing

I’m Insurance Sales

Client /customer problem solving. In claims

Multi-tasking between multiple offices

Handle day by day pricing. Underwriting policies for new businesses

Advantmed, LLC. 01/2015 – 08/2018

US Remote Call Center Representative / Customer Service Associate

Handle day to day verification process and make follow-up calls with the provider offices.

Bring finely tuned attention to detail and commitment to quality to all assigned tasks.

Kerrville State Hospital - Kerrville, TX 07/2014 - 12/2015

Psychiatric Nursing Assistant

§Recorded and maintained patient information such as vitals, eating habits, behavior, and progress.

§Listened and provided emotional support and encouragement to psychiatric patients.

§Completed physical checks and monitored patients to detect unusual or harmful behavior and reported observations.

Private Duty Care - Kerrville, TX 02/2011 - 06/2014. End

Home Health Aide

§Helped facilitate and contribute to a positive environment to enhance clients’ quality of life.

§Handled light housekeeping duties, prepared meals, and transported to locations outside the home.

Hill Country Memorial Hospital - Fredericksburg, TX 04/2006 – 02/2011

Patient Care Technician

§Provided assistance and care in accordance with resident care policies and procedures.

§Ensured the utmost safety and well-being of the residents.

§Completed daily logs documenting patient condition and activities.

§Followed HIPAA regulations and used medical terminology effectively.

Hilltop Village Nursing Facility - Kerrville, TX 04/2003 - 04/2006

Edge Water Nursing Home Facility - Kerrville, TX 06/2000 - 04/2003

Certified Nurse Assistant

§Responded appropriately to the physical, emotional, and developmental needs of the residents.

§Ensured that residents and families received the highest quality of service in a caring and compassionate atmosphere, recognizing the individual’s needs and rights.

§Maintained confidentiality of proprietary information.

EDUCATION

Ultimate Medical Academy Associate of Science in Health Sciences - Medical Administrative Assistant, 2017

Nursing Registry ID# 440*******

Notary since 2022

Auto insurance personal lines

ID# 3407669. Expired date 10/31/2023

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