Medical Records Customer Service
Resume:
Virjinia Sandoval
ADMISSIONS COORDINATOR
Katy, TX 77449
******************@*****.***
Professional Summary
Accomplished and energetic with a solid history of achivements. Motivitated leader with strong organizational and
prioritization abilities. Seeking for growth and ability to utilize skills obtained through education and work experience.
Work Experience
Admissions Senor Coordinator
Pediatric Home Service-Houston, TX
May 2023 to Present
• Build patient account gather and enter Medical records ensure correct supporting documentation is obtained.
• Received prescription for different Durable Medical Equipment Formula, Enteral Supplies, Ostomy, and Urological Supplies.
• Create the necessary paperwork to service the patient.
• T19, CCP, CPAP/BIPAPs, Ventilator, and Letter Of Medical necessity forms.
• Insurance verification via phone and on payer portals Medicaid all MCO and commercial payers.
• Authorization request and appeals for DME and Pre certification.
• Explenation of benefits COB and EOP.
• CPT coding HCPC collect Co-Pays or Co-insurance.
• Profitability and Cost Annalysis for supplies being rendered.
•Train new hires on different job functions.
•Replace any damage or missing supplies for patients. Patient Care Coordinator
Aveanna Healthcare-Houston, TX
August 2019 to Present
• Bilingual Leadership Team player
• Intake coordinator manage registration process of new patients needing medical service.
• Hospital discharges or pcp referrals
• Build patient account gather and enter Medical records ensure correct supporting documentation is obtained.
• Calculated formula dosage on filled prescription orders by MD.
• Create proper documentation that is required by insurance as well for any medical supplies patient may need.
• Verify eligibility via Brightree,N.C. Tracks portal, TMHP, and Availty.
• Request for prior authorizations and log authorizations accurately up on retrieval.
• Assist with change of perceptions for North Carolina retrieve prescription back and log to patients template. Abide by insurance guidelines and keep compliance.
• Assist with Texas Intake
• Make outbound and answer inbound calls for N.C, TX, and MI patients.
• Replace any damage or missing supplies for patients via McKesson.
• Assist with North Carolina recurring or Texas recurring orders.
• Assist with hand written tickets weather Texas or North Carolina patients.
• Take soup calls when needed defuse situations with upset patients and guarantee great customer service.
• Explanation of billing questions patients may inquire regarding commercial insurance copays and deductibles.
• Help team members weather translating or any questions they may have.
• Delivering fast, friendly and knowledgeable service for routine questions and service complaints.
• Evaluated customer account information to assess current issues and determine potential solutions.
• Exceeded team goals and collaborated with staff to implement customer service initiative's.
• Maintain QA satisfaction levels.
• Deescalate calls from upset customer's
• Transfer calls to the correct department.
• Collect payments for cash pay patients as well as any co pays.
• Explanation of Benefits deductible and out of pocket cost. Customer Service Representative
Numotion Medical Supply-Houston, TX
August 2018 to May 2019
• Durable Medical Equipment
• Make outbound and inbound calls and direct to individuals and departments
• Use of Bright Three to verify eligibility and benefits as well as other web portals Availity, TMHP, Optum, and clear wave for different state wide insurance.
• Process orders out on a month to month basis assist patients with defective products or missing items via cardinal health.
• Met or exceeded revenue objectives top producer for several months.
• Creat revisions for additional items fax over prescription renewals to doctors office.
• Follow up on with doctors offices for pending documentation as well as home health facilities for discharge patients.
• Creat ABNs for Patients whom have Medicare and need to purchase retail that exceeds Medicare quantity limits.
• Document conversations with customers in Brightree to track requests, problems and solutions offered.
• Collect payments and copay offer payment plans.
• Translate services for English person team to serve Spanish speaking customer needs.
• Consulted with upset customers to determine best methods to resolve services and billing issues,
• Issue out samples for new products or temporary supplies
• E-mailing and Faxing
CUSTOMER SERVICE REPRESENTATIVE
J&R Medical-Houston, TX
August 2017 to July 2018
• Durable Medical Equipment
• Inbound / Out Bound Calls
• Insurance Verification Medicare, Medicaid, and Comercial Insurance follow Medicare and Medicaid guidelines via multiple portals.
• Process monthly orders for Urological, Ostomy, Cecostomy, and Incontinence supplies.
• Return Exchange Products
• Payments Collect Copays for commercial plan patients.
• Doctor Office Follow Ups on CMN and insurance authorization.
• Collection Calls
• Data Entry
• Track doers or replace orders if lost or incomplete with product via Cardinal.
• Assisted Customer with Out Of Stock Products
• Guaranteed positive customer experiences and resolved all customer complaints.
• Top producer for 3 consecutive months straight
• Promptly responded to general inquiries from members, staff, and clients via mail, e-mail and fax.
• Bright green software
Education
Medical in Medical Assistant
Texas School of Business - Houston, TX
2010
High School Diploma
Texas Challenege Academy Military School - Sheffield, TX Skills
• Spanish
• Medical Scheduling
• Medical Office Experience
• Microsoft Excel
• Phone etiquette
• Employee evaluation
• Experience Administering Injections
• Phone Etiquette
• Call Center
• Phlebotomy
• Venipuncture
• CSR
• Microsoft Outlook
• Transcription
• HIPAA
• Patient Care
• Bilingual
• Medical Records
• Epic
• Time management (2 years)
• Customer relationship management
• Hospital Experience
• Translation
• Triage
• ICD-10
• Office experience
• Communication skills
• Personal injury law
• Quality Assurance
• Customer Support
• Microsoft Office
• Computer Skills
• Property Management
• Customer Care
• Intake
• Vital Signs
• Insurance Verification
• Analysis skills
• Medical Terminology
• Medical Coding
• Customer service
• Office Management
• Interpretation
• Customer Service
Certifications and Licenses
Certified Clinical Medical Assistant (CCMA)
Driver's License
First Aid Certification
Certified Medical Assistant
CPR Certification
Medical Assistant
October 2010
Additional Information
Skills
Ability to Work Under Pressure Bilingual
Decision Making Leadership
Time Management
Self Motivation
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