Workers Compensation Front Desk

PABLO YEPEZ

OBJECTIVE

Currently seeking an opportunity in a productive company as a Director of workers compensation Supervisor, in which I can utilize my bilingual and administrative experience, as well as permit me to further increase my abilities and provide an opportunity for advancement.

EXPERIENCE

2018-Current Advanced Diagnostics- Houston, Tx

Assistant Director of Workers Compensation services

Scheduling all workers compensation referrals for 4 doctors

Verifying compensability with workers compensation adjusters

Requesting PLN 11 for the disputed cases for a 1time eval

Requesting designated doctor reports for future treatment and accepted conditions

Calling workers comp attorneys for status on hearings and BRCs

Updating all referrals in RMS and keeping all referral appointments up to date

Scanning complete medical records into athena for doctors to review prior to initial appointment

Emailing referral sources initial appointment and follow up appointment

Handling all orders/emailing and faxing orders for scheduling

Daily reports sending reports to referring sources and updates on patient treatment

Once doctor orders surgery obtaining all complete medical records to submit for precertification with insurance carrier for approvals

Assisting obtaining approvals to schedule surgeries and injections

Obtaining Cost estimate reports for all lop surgeries

Case manager for 4 law firm

Scheduling all new lop patients

Scheduling follow up appointments and re-scheduling appointments

Daily meeting with upper management

Assisting patients with new patient paperwork

Emailing reports daily to case managers and handling orders

Coordinating appointment for out of towner patients

Monthly meeting with attorney case managers for status on medical treatment

Updating daily attorney spreadsheet with medical treatment status

2015-2018 Lonestar Orthopedics- Kenneth Berliner, MD Houston, Tx

New patient Coordinator

Scheduling new patients daily

Verifying commercial insurance blue cross/aetna/uhc/cigna/medicare

Verifying workers compensation/longshore/jones act referrals

Verifying dept of labor claims

Scheduling attorney new patients

Faxing deposit requirements for initial consultation

Running credit cards for initial visit

Posting credit cards daily for copays/initial visit deposits

Communicating with new attorneys for new business

Scheduling incoming email referrals/fax referrals

Making sure every new patient account is noted with complete notes of verification

Creating 73 forms for all workers compensation patients

Assisting patient with 53 Forms for change of treating doctor

Requesting medical records from emergency room/surgery center/doctors clinics

Scanning records into EMR system/mri/operative reports/x-ray/physical therapy notes

Contacting adjusters for approvals for treatment

Daily logs of incoming referrals

Booking new patients daily at every hour

Front desk scheduler/booking in follow ups

Giving follow appointments established patients

Covering front desk receptionist

Assisting spanish speaking patients with new patient paperwork

Translating for the doctor with spanish speaking patients

Creating EMR accounts in EMA

Meeting with new referring sources

Daily reminder calls for new patients

Making sure every account is completed for the next Clinic day

2013-2015 Resource Corporation of America Houston, TX

Lien specialist/Auto Dialer Supervisor

Patient support/making daily phone calls with patients

Daily meetings with HCA directors on payment revenues

Daily meetings with hospital administrators

Posting payments/adjusting balances

Filing liens on motor vehicle accidents accounts to secure payments

Screening accounts with third party auto insurance

Screening accounts with (Personal Injury Protection) to cover Emergency Visit charges

Mailing/faxing medical bills to auto insurances

Hippa request from Attorney’s office

Create daily mail outs to patients

Meeting with patients on a daily basis to set up payment plans

Monthly revenue reports

Auto dialer supervisor

In charge of opening contracts with hospitals

Billing private health insurances to cover medical bills

Requesting police reports, skip trace, patient home visits

Daily negotiations among attorneys

Signing off on final negotiations

Auto dialers/liens specialist morning team meetings

Training new hires/new hire paperwork

Pay roll/correcting employees time/adjusting time

Familiar with microsoft programs Word, Excel, PowerPoint, Internet and Outlook

Secure/artiva Software

10 Key

50 WPM

Copy Production knowledge

Scanning

Faxing

2012-2013 Amed Home Health Texas City, TX

Collections Specialist/Manager

AR- detail aging (status) keeping every account up to date

Request adjustment once the insurance carrier paid correctly

Request for reconsiderations/appeals if carrier did not pay accordingly

Meeting with upper management every month for AR status

E/B claims to molina healthcare, evercare, tmhp, amerigroup

Appealing no pays and resubmitting claims to reprocess

Insurance verification

Meeting with a group of four employees with A-R status Meetings

2006-2012 Surgery Specialty Hospitals of America Pasadena, TX

Workers Comp Collector

Contacting workers compensation insurance for claim numbers

Faxing claims/bills to the insurance carriers

Checking status on claims/medical bill

Preparing OPPS calculators and IPPS

Request adjustment once the insurance carrier paid correctly

Request for reconsiderations/appeals if carrier did not pay accordingly

AR- detail aging (status) keeping every account up to date

Meetings with upper management on workers compensation accounts

Estimated revenue reports every first of the month

Legal third party collector/legal assistant

Contacting attorneys to check case status on lop accounts

Once case settled requesting distribution list

Preparing proposal agreement/negotiations for upper management approval

Case adjustments, once payment has been received

Meeting with attorneys to discuss all lop accounts

Calling and sending patients statements if case was not awarded any money

Keeping lop excel up to date with payments/ status on every account/trial dates/payments.

Self Pay Collector/Commercial Insurances Collector

Helping spanish speaking patients with their outstanding bills

Running self pay credit cards for payments

Collecting on commercial insurance such as Aetna, Blue cross, United Healthcare, Aetna, Medicare, Medicare HMO, Medicaid

File clerk

Appealing no pays and resubmitting claims to reprocess

Medical records

Picking up medical record charts from the OR once patient is discharge

Prepare In patient and Out patient charts for coding

Fax operative reports to all physicians

Transcriptions

Preparing medical records once requested by attorneys or patients

Maintaining all medical records in file by medical record number

2005-2006 Docu-Copy Management Houston, TX

Site manager

Customer service

Photocopy production

Mail room manager, sort mail, distribute Fed Ex/UPS Packages, supply clerk, distribute mail, 50 WPM.

Responsible for conference room set ups an00000000d general office services.

EDUCATION

2007-Current San Jacinto College Pasadena, TX

Vision Care

Certificate of Eye Care

2002-2006 Pasadena High School Pasadena, TX

Diploma

REFERENCES

Upon request

***********@*****.***, 1508 Jessie Lane., Pasadena Texas 77502, 281-***-****

Contact this candidate