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Click here or scroll down to respond to this candidateCandidate's Name
Pinellas Park, FL Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLETo build a long-term career with opportunities for career growth. To enhance my educational and professional skills in a stable and dynamic workplace. Ive been in the medical field for a very long time. I knew from a very long time that my passion was helping people. I am the person that will see an accident, stop and make sure everyone is ok and that they stay where they are to not cause any further injuries. Im the person who helps those that are not technology savvy check in to a kiosk. Ive been on the front lines with the patients and also behind the scenes. I have an infectious attitude and smile that even over the phone makes patients feel comfortable. I want to solve problems in a creative and effective manner in a challenging position. Work ExperienceMed Tech/Resident Care AideBaybrook of Largo - Largo, FLMay 2023 - August 2023Assisting residents with ADLsPassing medication to residentsMemory CareCustomer Service Representative/CashierFamily Dollar - Pinellas Park, FLDecember 2021 - February 2023Attend and check out customersStockKeep store clean and hazard freeClose store and verify depositClinical Documentation SpecialistBioGX - Saint Petersburg, FLMay 2021 to October 2021Called or emailed physicians and 3rd party vendors to obtain medical records per CMS guidelines to get status. Prepare documents for audits or Appeals. Opened and sorted mail. Scanned to appropriate employees or folders. Other duties as requested by management. Intake SpecialistPathema Group, LLC - Largo, FLMarch 2021 to April 2021Furloughed without paySpoke to patients who had an interest in cardiac genetic testing and made sure they are qualified, one if its a covered benefit of their insurance and two, if its medically necessary. Appeals SpecialistParallon - Largo, FL/Nashville, TN Corporate WFHJuly 2015 to November 2021Triaging accountsInteracts with other departments including Customer Service, Collections, Underpayments, Overpayments, Revenue Integrity, Case Mgt, PAD, Coding, etc. (eRequest)Mentor and train new employeesLiaison in corresponding and communicating with providersConduct general appeal research including, but not limited to, requesting waivers of liability and/or appointment of representative forms, requesting member medical records, organizing documentation, documentation of the appeal resolutionPerform special projects as neededSubmit Contractual Adjustments, Write-Offs, and Variance AdjustmentsAssist financial team with the confirmation and closing of financial activities in ConcuityUploading Appeals to payer websitesUsing payer websites to obtain Appeal/Claim statusCompiling and mailing of appeals to providersCompiling, sending, and documenting of payer spreadsheetsComposing of tech appeal lettersServer/BartenderBuffalo City Bar & Grill - Saint Petersburg, FLMarch 2014 to May 2015Responsible for stalkingOrdering suppliesSeating guestsTaking food/beverage ordersCleaning/Closing dining areaCounting drawer at end of shiftInsurance AgentBankers Life & Casualty Company - Saint Petersburg, FL November 2012 to August 2013Life insurance/AnnuitiesMedicare supplements/Medicare advantage plansCritical care insurance/Long Term CareCertified Nursing AssistantNorthside Hospital - Saint Petersburg, FLJuly 2010 to March 2012Rounding patient roomsAmbulating patientsVital signsBedpansMouth careAssisting patients with ADL'sBed bathsBed makingDocumenting I&O'sEmptying foleysTransferring patientSetting up telemetryCollecting specimensPost mortem careSurgery CoordinatorEar, Nose, and Throat Associates - Clearwater, FLNovember 2006 to September 2009Insurance verificationMulti-line phone systemTriageKnowledge of insurance plansSurgery schedulingVerbalizing instructions to patientsCollectionsDiagnosis/Procedure codingAuthorizations/ReferralsInputting Demographic infoObtaining Medical recordsMedical AssistantOBGYN PA - Saint Petersburg, FLSeptember 2005 to October 2006Filing InjectionsVital signs Multi-line phone systemPost-surgery follow upInsurance verification/Computerized eligibilityAccounts payablePatient reminder callsMedical and surgical asepsisSterile proceduresTriagePhlebotomyPregnancy testingUrinalysisDressing changesPrescription refillsInputting demographic/InsLaboratory testing follow upChart prepStaple/Stitch removalMedical recordsCollectionsFront Office CashierPublix - Saint Petersburg, FLJanuary 2001 to April 2003LottoCustomer serviceCheck outDepositsVerifying tenderLeveling/cleaning storeEducationBachelors of Science in Health Care ManagementCalifornia Coast University - Santa Ana, CAApril 2019 to PresentHigh School DiplomaPinellas Park High School - Largo, FLAugust 1999 to May 2003Languages Portuguese - Expert Spanish - ExpertSkills Excellent organizational skills Superior telephone etiquette and verbal/written communication Self-motivated & Goal Oriented Overachieving and enthusiastic work ethic High level of professionalism and integrity Experience with supervising and training Remarkable time management skills Proficient in Word, Excel, Outlook, Power Point Payer Websites Medical collection Managed care Medical Records/EMR Systems Critical Care/Hospital Experience Insurance Verification Medical Coding, ICD-9 & ICD-10 Identifying differences in materials, following instructions, and detecting details among distracting information. Addressing concerns and using sensitivity when responding to needs and feelings of patients Reliable, dependable, and act with integrity at work Identifying and resolving common customer/patient issues Transcribing text using a standard keyboard Performing basic computer operations, navigating a Windows OS, and troubleshooting common computer problems. Knowledge of EHR data, associated privacy regulations, and best practices for EHR use Level of motivation and discipline applied toward work Speaking clearly, correctly, and concisely Prioritizing case tasks, gathering information, and providing services without judgment Managing practitioner schedules and maintaining accurate patient records REFERENCES UPON REQUEST |
