SUMMARY
Bi-lingual (English/Spanish) individual with experience in medical billing, insurance claims analysis, customer service, training, and retail management. Seeking a management or administrative position with long-term potential and opportunities for expanded responsibility and career growth.
EXPERIENCE
South Carolina Medical Management Greenwood, SC 2010 - 2011
Bilingual Account Representative 2010 - 2011
Recommended and headed up a project to automate workflow tracking in order to save paper and time spent on daily activities which also provides tools for balancing the end of month accounting books
Recommended procedures for following up on rejected and pended claims
Created a program to extract raw data and put it into a workable format for use in our office based on workflow needs
Participated in new client implementation projects and recommended ways to reduce time spent on account reconciliation for our new clients
Translated all patient communications into Spanish in order to maximize collections from our Spanish speaking patients
Reconciled patient accounts with monies received
Contacted insurance companies to follow up on denied claims
Communicated with provider’s offices to reconcile patient accounts accurately and efficiently
OptiCare Managed Vision Rocky Mount, NC 2009 - 2010
Bilingual Customer Service Representative 2010
Decreased time spent by Providers filing claims by educating them on proper claim filing procedures
Increased the number of Customer Service Representatives who are capable of answering questions regarding the processing of claims
Increased the knowledge base of co-workers by providing supplemental learning opportunities
Helped department consistently meet or exceed our abandonment rate goals
Achieved high levels of customer satisfaction through phone conversations with members and providers in English and Spanish
Claims System Analyst 2009 - 2010
Built benefit plans into our claim processing system to efficiently process claims
Increased the productivity of the Claims Team by providing them with accurate training materials for new health plans and benefit changes
Suggested improvements to the Claims processing software to increase the number of claims that can be processed without human intervention
Assisted our Provider Relations department in implementing special fee schedule requests to satisfy provider quotas in remote areas
Suggested new ways of entering fee schedules into our software in order to take advantage of software enhancements and reduce the number of reports that have to be worked manuall...
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