Insurance Verification Data Entry

Stephanie Guzman

Candidate Location: San Antonio, TX

Open interview availability

Relevant Skill Set:

• 18+ years of healthcare experience

• Knowledgeable with the authorizations and referrals process, medical terminology, ICD-9, and ICD-10 coding, data entry, medical records, office management, medical office, CPT coding, medical scheduling, and insurance verification.

• MS office proficient, EMR systems, eClinicalWorks, QuickBooks OMG Technologies

Molina Healthcare - Care Management Processor

October 2023 – January 2024

• Processing of authorizations and follow-ups for DME, MHM, DAHS,PAHS, RESPITE and reductions/denials

• Follow ups with members, maintaining extremely accurate tracking for reporting, satisfactions surveys, emails, and urepointploads into TruCare upon work completion and receipt of completed forms.

• Submit referrals, review BID and follow-up on status of BIDs.

• Obtain required forms (landlord approval, 2416)

• Submit cases for medical review when necessary.

• Obtained proper documentation for DME from Assigned Reps for equipment

• Generated authorities

• Insurance Verification

• Excel

• Microsoft Word

• HERO

• Web Del

• Spreadsheets

• Microsoft Teams

• Sharepoint

• QNXT

• CCA

• PEGA

Aston Carter

3M KCI USA

March 2023-June 2023

• Obtained proper documentation for DME from Assigned Reps for equipment

• Generated authorities

• Insurance Verification

• Excel

• Microsoft Word

• HERO

• Web Del

• Spreadsheets

• Microsoft Teams

Ph: 210-***-**** Email: *******@*****.***

Stephanie Guzman

Candidate Location: San Antonio, TX

Open interview availability

• Sharepoint

Professional Experience:

Superior Health Plan

August 2022-February 2023

Program Coordinator (Specialty Authorization Team)

• Processing of authorizations and follow-ups for DME, MHM, DAHS, and reductions/denials

• Follow ups with members, maintaining extremely accurate tracking for reporting, satisfactions surveys, emails, and urepointploads into TruCare upon work completion and receipt of completed forms.

• submit referrals, review BID and follow-up on status of BIDs.

• Obtain required forms (landlord approval, 2416)

• Submit cases for medical review when necessary.

Dr. Robert Nobles

December 2017 to August 2021

Front Office Coordinator

• Check in and check out patients.

• Answer multiple phone lines

• Insurance verification

• Generated referrals.

• Checked patient vitals

• Worked on MOMS system

• EKG’S and ABI’S

Renal Associates LLC

November 2013 to August 2017

Referral Coordinator

• Generated referrals in a timely manner

• Verified insurance.

• Worked with ECW

Dr. Arthur Hernandez

September 2011 to November 2013

Front Office Coordinator

• Pleasantly welcomed visitors, answered phone calls, and maintained front reception desk.

• Oversaw insurance verification.

• Generated referrals and authorizations.

• Worked on MOMS and DUXWARE EMR

• Pleasantly welcomed visitors, answered phone calls, and maintained front reception desk.

• Oversaw insurance verification.

• Generated referrals and authorizations.

• Worked on MOMS and DUXWARE EMR

Institute For Women's Health

August 2009 to August 2011

Insurance Verification Specialist/Patient Referral Coordinator

• Verified that patients had the proper insurance coverage prior to any procedures or appointment scheduling.

Stephanie Guzman

Candidate Location: San Antonio, TX

Open interview availability

• Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.

• Updated all patient and insurance data regularly and carefully inputted changes into company's computer system.

• Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.

• Provided excellent service and attention to customers when face-to-face or through phone conversations.

Education:

High school diploma, McCollum High School - San Antonio, TX

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