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Skills
  • Bilingual(Spanish)
  • Customer service
  • Excellent Communication Skills
  • Great organizational skills
  • Knowledge of MS Office & ECW
  • Data Entry
  • Recordkeeping
Professional Summary
  • Organized Patient Service Representative with 2 years of experience in healthcare. Adept at patient advocacy and education with commitment to efficiency. Skilled at coordinating busy offices and maintaining professionalism in stressful situations.
Work History
Party Planner Self- Employed - Rome, GA 08/2019 - Current
  • Interviewed clients to understand event scopes of work, establish budgets and determine timelines for venue selection, guest list finalization, and rehearsal, ceremonies, and receptions.
  • Coordinated florists, photographers, videographers, musicians, officiants and ceremony participants during rehearsals and pre-ceremony, ceremony and reception events.
Patient Representative Hudson River Health Care - Monticello, NY 01/2017 - 08/2019
  • Schedule appointments, register patients , verify insurances and demographics are accurate.
  • Correctly code and bill medical claims for various Medical Providers.
  • Entered orders into the ECW system efficiently and without errors.
  • Prepare patient charts accurately and neatly for the Health Center.
  • Evaluate patients' financial status and established appropriate payment plans.
  • Update patient financial information to guarantee accuracy.
  • Interact with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.
  • Treated all patients, their families, visitors, peers, staff and providers in a pleasant and courteous manner.
  • Confirmed accurate completion of forms/consents of treatment and collect financial information for the uninsured.
Direct Care Professional Sullivan Arc - Monticello, NY 11/2007 - 08/2017
  • Providing individual support to adults with developmental and physical disabilities .
  • Advocate for people with the unique abilities and challenges so that they can achieve an optimal quality of life.
  • Work directly with the people residing in residential homes in order to maintain a safe and supportive environment that fosters growth and facilitates the development of independent skills.
  • Provide supports tailored to the needs and desires of each individual person.
  • Assisting individuals with completion of daily living such as: Bathing,dressing, eating and cooking
  • Administering Medications, Transportation with use of agency vehicles , planning daily activities including; skill building, money management ,grocery shopping and medical appointments.
  • Maintaining a clean and safe environment . Maintaining all of their medical needs.
Child Care Provider Leslie's Daycare - monticello, NY 09/1999 - 11/2007
  • Early childhood/Child care provider managing an in home daycare with 2 infants, 4 Toddlers/preschoolers and 2 school aged.
  • Operated Leslie's Daycare in accordance with New York State licensing standards and regulations.
  • Developed age-appropriate activities and programs for children infants to toddler ages in pre-school environment .
  • Managed Food inventory for an 8 person child care in accordance with nutritional guide lines of The Child Care Council.
  • Maintained accurate detail and updated records on children with important information such as attendance, allergies, emergency contact information and incident reports.
Education
Associate of Applied Science: Criminal justice SUNY Sullivan - Loch Sheldrake, NY 2013

This resume is created in 7 minutes.
Summary
  • A self-motivated professional with over 25 years in office administration with excellent client and project management skills.
  • Action-oriented with strong ability to communicate effectively with technology, executive, and business audiences.
  • Experienced in medical records file management and assembling medical records per medical, regulatory, legal, administrative requirements.
Skills
  • Operations management
  • Exceptional time management skills
  • Computer proficient
  • Results-oriented
  • Client-focused
  • File/records maintenance
Experience
Brooklyn, New York HIP Center/ Apr 1993 to Mar 2018
Patient Representative
Jan 2011 to Mar 2018
  • Performed point of service activities for health facility including visit preparation, patient registration, co-pay collection, patient tracking and medical record retrieval.
  • Maintained effective communication with patients, peers and other members of the health care team while maintaining strict confidentiality.  
  • Provided administrative support for department.
  • Demonstrated working knowledge of computerized appointment scheduling system, insurance processing or other related office functions.
Medical Office Specialist
Mar 2005 to Jan 2011
  • Developed an in-house clerical system to effectively turn around attorney and third-party HIPAA requests by 50%. 
  • Effectively controlled the release of proprietary and confidential information of patients. 
  • Reviewed and provided comments on the adequacy of documents and took necessary steps to cure any deficiencies.
  • Provided administrative support for department.
Medical Records Manager
Jan 1997 to Mar 2005
  • Created an efficient in-house filing system to accommodate the daily workflow of ten (10) doctors resulting in a promotion to manage the medical records department. 
  • Monitored multiple databases to keep track of all company inventory.
  • Reviewed and provided comments on the adequacy of documents and took necessary steps to cure any deficiencies.  
  • Provided onsite training to new hires.
Messenger
Apr 1993 to Feb 1997
  • Created and implemented an in-house mail system for the medical facility resulting in 80% increase in efficient mail distribution throughout the company. 
  • Managed all incoming and outgoing correspondence distribution of facility while maintaining strict document confidentiality.
  • Provided onsite training to new hires  
Education and Training
High School Diploma Automotive High School Brooklyn, New York

This resume is created in 7 minutes.
Professional Summary
A highly organized and detail-oriented criminal justice graduate seeking a position to contribute my skills and ensure my growth through the organization.
Education
Bachelor of Science: Criminal Justice with a Minor in Public Management, 2016
Austin Peay State University - Clarksville, TN
Skills
  • Fluent in English, Spanish, verbal and written.
  • Flexibility, adaptability, managing multiple priorities.
  • Ability to identify and analyze social problems and develop solutions.
  • Proficient with MS Word, Excel, and PowerPoint.
Work History
Referral Coordinator, 02/2018 to Current
UF Health Proton Therapy Institute Jacksonville, FL
  • Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout the process.
  • Tracked prior authorizations from patient's insurance companies for Radiation Therapy such as Proton Beam Therapy, IMRT, SBRT, and Photon.
  • Effectively communicate patient account inquiries, and resolve insurance and billing issues by utilizing all resources for account resolution.
Referral Coordinator, 02/2018
Baptist MD Anderson Cancer Center Jacksonville, FL
  • Provide referral assistance to physicians, patients, and insurance companies.
  • Obtain authorizations for diagnostic testing, surgeries, chemotherapy, and radiation.
  • Schedule appointments and collects patient responsibilities at the time of scheduling.
  • Provide exceptional service while communicating in a manner consistent with the goals and objectives of the Department.
Medical Billing Office Clerk, 11/2012 to 05/2014
Jennie Stuart Medical Center Hopkinsville, KY
  • Review claims for secondary insurances.
  • Follow up claims for Commercial insurances and Workers Comp.
  • Manual and Electronic Remittance posting of all insurance and patient payments.
Bilingual Business Patient Representative, 07/2010 to 10/2012
Mathew Walker Health Center Clarksville, TN
  • Monitor the billing and collection process.
  • Verified patient demographic and insurance information.
  • Assisted patients with medical records request and schedule appointments.
Bilingual Customer Service Representative, 09/2004 to 07/2010
Clarksville, TN
  • Credit cards, checks and cash handling experience.
  • Offered world class customer service for inbound calls.
  • Provide tier 1 basic technical support for wireless phones.

This resume is created in 7 minutes.
Skill Highlights
  • Insurance eligibility verifications
  • Billing and coding
  • Medical terminology
  • College coursework, including Anatomy and Physiology, Medical Terminology, and Pharmacology
  • Schedule management
  • Dedicated team player
  • Strong interpersonal skills
  • Active listener and quick learner
Professional Experience
Appeals Representative 02/2017 Current UnitedHealth Care Dallas, TX
  • Research and review all types of appeals and grievances. 
  • Utilize appropriate claims processing systems to ensure that the claim is processed appropriately.
  • Make appropriate determinations about whether a claim should be approved or denied based on available analyses/research of claims information.
  • Work with applicable business partners to obtain additional information relevant to the claim.
  • Document final determination of appeals or grievances using appropriate templates, communication processes, etc. 
  • Communicate appeal or grievance issues/outcomes to all appropriate internal or external parties. 
Clinical Administrative Coordinator 11/2015 02/2017 United Health Group - Optum Home Health Dallas, TX
  • Prepare and send patient reports to physicians and insurance case managers on weekly basis.
  • Manage medication orders for patients daily and as needed from pharmacy and distribution center.
  • Prepare and manage patient billing and reports.
  • Answer incoming phone calls and route to the appropriate team member.
  • Accurately document phone/voice mail messages and distribute timely according to service provided.
  • Obtain and track all physician signatures on all incoming verbal
  • orders.
  • Train new hires on administrative tasks.
  • Perform general administrative duties as assigned.
  • Maintain all Phoenix medical records.
Auditory Trainer 03/2013 11/2015 Mesquite Independent School District Mesquite, TX
  • Provided auditory training in compliance with individualized education plans for deaf education students.
  • Consulted with campus audiologist to maximize student progress towards IEP goals.
  • Assisted in the implementation of the curriculum under the direction of the teacher.
  • Maintained confidentiality of students and their families.
Front Office Specialist 04/2014 01/2015 First Choice Emergency Room Richardson, TX
  • Obtained demographic, insurance verification and financial data to complete registration.
  • Greeted patients and provided paperwork.
  • Updated and maintained patient database.
  • Completed and balanced all daily transaction paperwork.
  • Maintained an open line of communication with all team members.
Insurance Verification 12/2012 03/2013 Texas Regional Medical Center Sunnyvale, Texas
  • Responsible for verification and precertification of insurance, including commercial insurance, worker's compensation, and state programs, for pre-admitted, admitted, or discharged patients.
  • Determined patient responsibility, if applicable, and notified patients of deductibles or copays.
  • Created and updated patient accounts with benefit information.
  • Completed telephone and online verification with multiple insurance providers.
  • Maintained knowledge of ICD-9 codes.
Unit Secretary 09/2009 12/2012 Texas Regional Medical Center Sunnyvale, Texas
  • Answered telephones, took messages, and greeted visitors.
  • Scheduled cesarean sections and inductions.
  • Transcribed physician orders.
  • Worked closely with nursing personnel, medical staff, and the public.
  • Maintained patient charts and medical forms.
  • Input unit charges and delivered specimens and transports patients.
Admitting Representative 10/2008 01/2010 Methodist Richardson Medical Center Richardson, Texas
  • Obtained current and accurate demographics and insurance information in order to register patients.
  • Verified insurance coverage and eligibility via phone, fax, and/or online.
  • Customer service provided through answering phones and assisting patients.
  • Ran nightly reports and accurately balanced daily payments.
Surgery Scheduler 08/2007 07/2008 Pinnacle Anesthesia Dallas, TX
  • Responsible for CRNA and anesthesiologists' surgery schedules through provided computer software.
  • Collected patient's demographic and billing information in order to schedule them appropriately.
  • Coordinated with 50 doctors and 22 medical centers to assist in scheduling anesthesia needs.
  • Communicated with CRNAs and anesthesiologists on their availability for anesthesia needs in emergency situations.
Unit Secretary 02/2006 12/2007 Richardson Regional Medical Center Richardson, TX
  • Answered telephones, took messages, and greeted visitors
  • Transcribed physician orders with accuracy.
  • Utilized various types of office equipment to include intercommunications system, computer, fax and copier.
  • Worked closely with nursing personnel, medical staff, and the public.
  • Maintained patient charts and medical forms Input patient charges.
Access Services Representative 04/2007 08/2007 Baylor Specialty Hospital Kelly Services Dallas, TX
  • Answered phones, greeted visitors, and sorted incoming mail.
  • Input physical, speech, and occupational therapy charges for Our Children's House and Baylor Specialty Hospital.
  • Provided daily spreadsheets regarding patient charges.
Patient Representative 01/1999 01/2002 PrimaCare Medical Center Dallas, TX
  • Obtained current and accurate demographics and insurance information in order to register patients.
  • Verified insurance coverage and eligibility via phone and fax.
  • Assessed correct billing information and collecting patient payment.
  • Customer service provided through answering phones and assisting patients.
  • Ran shift end reports and accurately balanced daily payments.