Santa Teresa NM *****
Linda Michelle Hernandez
To attain a position that will allow me to utilize my full business and professional medical experience and knowledge to its full capacity.
Summary of qualifications
Bilingual-ability to read, write and speak fluently in English and Spanish
Microsoft Word, Microsoft Works, Windows, Excel
Proficiency with office equipment to include multi-line phone, fax, 10 key, copier
Electronic Billing of Medical Claims
Data Entry of Claims with Medicare FSS system
Financial review and counseling to include patient surgical estimates and payment arrangements
Monthly financial reporting
1989-1993 Bachelors Degree of Business Administration, Management
New Mexico State University
Physician Business Manager; Wellmed (Optum)
Providing provider relations to contracted and affiliated providers
Assist in contracting issues
Assist in completing quality measures
Practice Manager; Providence Medical Partners
Supervised registration and medical staff for a multispecialty clinic. Produced financial reports for monthly clinic reporting to administrators. Reviewed and maintained monthly budgets. Reviewed and assisted in maintaining KPIs (Key Productivity Indicators) at a standard measure as required of our clinics. Reviewed accounts with incorrect insurance payments for possible insurance reprocessing or appeals needed. Maintained exceptional customer service for both internal and external customers. Managed provider credentialing status with insurance payers remain active. Managed provider expense reporting and reimbursements processing. All other duties as assigned.
Pre-Certification Specialist; El Paso Specialty Hospital
Assisted in managerial duties with financial reporting of Revenue cycle and Business Office practices, Assisted in handling patient complaints to ensure proper customer service, Assisted in overseeing 5-7 Registration department staff; reviewed daily surgery schedules to ensure adequate authorizations were in place for proper reimbursement, Compared and reviewed reimbursements with hospital payer contracts, reviewed and attained necessary authorizations/notifications for inpatient and outpatient procedures scheduled, Assisted in necessary appeals and collection follow up on accounts, Calculated patient financial estimates of responsibility based on insurance contracts and insurance benefits verified, Contact patients and assist with financial payment arrangements. Handled third party liability accounts with attorney offices through letters of protection, Direct communication and work with CEO and CFO with any issues at hand and any other duties as assigned.
Patient Account Representative; Patient Financial Services, University Medical Center
Management of clinic and hospital accounts with commercial, worker’s compensation and managed care plans. Ensuring prompt reconciliation of accounts with insurance payments. Conducting necessary appeals either by phone or paper for timely reconsideration of denied claims. Reviewing account information to include registrations and insurance plans to assist in denials of claims on accounts. Electronic billing of medical claims both professional and technical. Other Duties as assigned
Office Manager; La Clinica De Familia Inc.
Supervised 7-8 employees per site, posted charges into patient’s accounts for billing department to generate claims, provided monthly reports to administration on the productivity output of the medical site, handled patient complaints, medical records management, conducted peer audit on proper functionalization of the clinic site, worked on the collection of both current and past due accounts, scheduled appointments of both in-house and outbound referrals.
James Wilcox 909-***-****
CEO; Legent Hospital – CEO at previous employer
Sylvia Gallardo 915-***-****
Market Decision Support Analyst; THOP East Campus – Previous supervisor
Emilia Avila 915-***-****
Retiree Coordinator; City of El Paso – Previous Coworker-Friend
Michelle Lorilla 915-***-****
Lien Specialist; UMC El Paso – Previous Coworker-Friend
Rocio Medrano 915-***-****
Student support staff; SISD – Previous Coworker-Friend