Sandra Martinez

**** **** **** **** ******, CA **033 805-***-**** adoya9@r.postjobfree.com

PROFESSIONAL PROFILE

Customer service oriented professional, capable of providing timely and accurate data to ensure reimbursement for patient services. Backed by 9+ years healthcare industry and call center experience. Follows policies, procedures and guidelines to ensure consistent quality.

oCommunicate in a clear and concise manner to ensure satisfactory customer service

oAble to work in a deadline-driven environment and meet company guidelines for productivity and quality

oFunction independently with minimal direction and guidance

oMicrosoft Office Applications / MS Word Typing Speed: 30 WPM

KEY QUALIFICATIONS

Medical Billing Accounts Receivable Collections Co-Pay Deductibles Co-Insurance EOBs

Revenue Cycle Management Posting Payments Government (Medicare & Medicaid) Third Party Payers

Electronic Health Records (EHR) Electronic Medical Records (EMR)

Managed Care (HMO, PPO, and POS) Workers Compensation

Insurance Verification Insurance Claim Processing CMS 1500 CMS 1450 (UB-04)

Front Office Operations Medical Office Procedures Scheduling

Medical Terminology Anatomy & Physiology HIPAA Compliance Medical Coding (ICD-10-CM, HCPCS, CPT)

EDUCATION

Ultimate Medical Academy Associate of Science Degree – Medical Billing and Coding, 2021

Ultimate Medical Academy HIPAA Essentials for Healthcare Professionals Certificate

WORK EXPERIENCE

Stay-at-Home Parent – Oxnard, CA 01/2011 – Present

Homemaker

oShow strong leadership skills and manage household budget

oRemain deadline-oriented and reliable while adjusting priorities and managing time wisely

oRequired to make quick, crucial and often unprecedented decisions

oAble to maintain a fair, consistent set of standards

oExcellent listening and delegation skills

oSuccessfully foresee and plan for possible contingencies

oProvide encouragement, support, and access to activities that enable the development of skills

Blue Cross – Camarillo, CA 09/2001 – 12/2010

Customer Service Representative - Call Center

oChecked to ensure that appropriate changes were made to resolve customers' problems

oCompleted contract forms, prepared change of address records, or issued service discontinuance orders

oDetermined charges for services requested, collected deposits or payments, or arranged for billing

oKept records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken

oReferred unresolved customer grievances to designated departments for further investigation

oReceived incoming calls to verify insurance coverage and reviewed billing information for patient accounts

oLocated coverage for major risk patients who needed supplemental insurance, including enrollment

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