Customer Service Virtual Assistant
Resume:
Miosotis Cruz
*** ********* ******, *****, ** ***54, 347-***-****, **********@*****.***
SUMMARY OF QUALIFICATIONS
Healthcare Billing and Management Expertise:
Over twenty years of experience in healthcare billing and management roles.
As a Certified Life Coach I can inspire alongside
Payment Collection and Explanation:
Successfully collect payments for patient visits and diagnostic studies.
Skillfully explain charges to patients to ensure clarity and understanding.
Patient Care and Urgent Complaint Handling:
Exercise sound judgment in addressing urgent patient complaints.
Information Verification and Patient Registration:
Thoroughly verify patient information and update charts as necessary.
Efficiently register patients with meticulous attention to detail.
Patient Communication Skills:
Provide accurate and detailed information to patients.
Customer Service Excellence:
Proven ability to deliver positive customer service to patients and clients.
Technical Skills:
Proficient in MS Office Suite.
Language Proficiency:
Bilingual in Spanish and English, ensuring effective communication with diverse patient populations. Basic knowledge of Madarin Chinese
• WORK EXPERIENCE
Oct 2018 – Current
NEW YORK PRESBYTERIAN HOSPITAL – New York, NY
Patient Accounts Representative
EPIC System Proficiency:
Efficiently manage patient records and billing using the EPIC system.
OnBase System Expertise:
Utilize OnBase for scanning, storing, retrieving, and indexing documents.
Collaborate with team members during digital automation testing of OnBase.
Financial Support:
Facilitate check distribution within the department as required.
Assist colleagues with resolving technological issues.
Process, batch, and scan patient documents and Index to appropriate accounts.
Correspondence Management:
Support the Correspondence Unit in managing incoming and outgoing mail.
Digital Transformation Initiatives:
Aid in implementing digital transformation projects within the finance department.
Billing and Collections:
Ensure accurate billing and prompt payment collection from patients.
Adjust payer mix credits in the Eagle System as needed.
Review credit balances and initiate refunds when necessary.
Customer Service Excellence:
Provide exceptional customer service to patients, legal representatives, and other correspondents.
Special Projects and Support:
Assist supervisors with various special projects as assigned.
May 2018-Oct 2018
WESTCHESTER JEWISH COMMUNITY SERVICES – White Plains, NY
Billing Coordinator
Payment Processing:
Record and post payments accurately in the Practice Management System (Anasazi).
Electronic File Management:
Upload electronic files into the Anasazi practice management system.
Financial Support:
Collaborate with the team during monthly financial closes to ensure accuracy and completeness.
Assist with special projects under the guidance of the supervisor, such as updating rates in the practice management system.
May 2016 – May 2018
COORDINATED BEHAVIORAL CARE – New York, NY
Accounts Receivable Manager
Relationship Management and System Reconciliation:
Managed relationships and development with GSI, BTQ, and MAPP.
Reconciled data across GSI, BTQ, and MAPP systems.
Patient Network Oversight:
Oversaw patient reassignments within the network.
Customer Service and Support:
Responded to network CMAs' enrollment, billing, and contracting inquiries.
Professional Development and Compliance:
Participated in webinars and external meetings to stay updated on policies and practices.
Informed and educated the network on regulatory changes.
Financial Oversight:
Verified receipt of PMPM payments from the network.
Additional Responsibilities:
Performed additional duties as assigned.
Expertise and Skills:
Knowledgeable in Medicare and Medicaid billing regulations, medical/outpatient coding, and NCCI.
Possessed strong oral and written communication skills.
Demonstrated exceptional human relations and leadership abilities in a team environment.
Proven ability to achieve superior performance in a unionized environment.
October 2001 – April 2016
THE CHILD CENTER OF NY – Woodside, NY
Clinic Billing Manager (former Assistant Billing Manager)
Team Supervision and Leadership:
Supervised Medical Billing Lead and Associates, ensuring timely completion of assignments.
Revenue Cycle Management:
Managed revenue cycle activities, including patient account analysis and coding, with one year in leadership.
Reviewed and corrected claims for errors to ensure accurate submissions.
Encounter Data Management:
Monitored submission of encounter data (HCFA 1500) to health plans.
Claim Denial Management:
Analyzed and resolved claim denials within 30 days.
Billing Oversight:
Oversaw billing processes for Medicaid, HMO, Medicare, and other funding sources.
Reporting and Documentation:
Generated and maintained comprehensive billing reports.
Prepared required medical billing documents for audits.
Policy Implementation:
Implemented Medicaid Transportation Reimbursement Policies and Procedures
PTAR (Public Transportation Automated Reimbursement System).
System Management and Compliance:
Maintained credentials for licensed workers in the Practice Management System (Anasazi).
Monitored database and Electronic Health Record (EHR) systems for data integrity.
Handled payer-mix credentialing and DEA licensing renewals.
Ensured HIPAA compliance and managed statistical data for accounting.
EDUCATION
NEW YORK UNIVERSITY, New York, NY- Expected Graduation Spring, 2025
Master’s Science in Project Management, Began Fall 2023
MONROE COLLEGE, Bronx, NY – JUNE 2014
Master’s Business Administration (MBA), Health Care Concentration, June 2014
MONROE COLLEGE, Bronx, NY – APRIL 2012
Bachelor of Business Administration, Health Services Administration, April 2012
THE COLLEGE OF TECHNOLOGY-New York, NY
Associate of Applied Science, Office Technology-Medical Track, June 2003
*Specialty- Health Care
CERTIFICATION
Certified Mental Health First Aid USA 3/15/2018-3/14/2021
oNational Council For Behavioral Health
Certified Professional Life Coach
oInternational Association of Professional Recovery Coaches
CUNY-Bronx Community College
AFFILIATIONS
Member, Project Management Institute, September 2018-current
Former Member, Toastmasters International, Monroe College, July 2014-2016
VOLUNTEER ACTIVITIES
Team Leader, New York Cares, November 2011-2014
Mentor, Public Color, February 2015-2014
SPECIAL SKILLS
Proficient in computer applications and software.
Excellent verbal and written communication skills.
Deep understanding of insurance procedures.
Experienced in customer service within a service-oriented environment.
REFERENCES FURNISHED UPON REQUEST
Contact this candidate