Experience

Euro-Center

• Czechia
• Insurance
• 100 - 200 Employee

• Claims Review Specialist

  • Dec 2022 - Present

  - Reimbursement/ClaimProcessing - ObtainingInvoice’sandverifyofauthorizations - WorkedwithinUHCportal - WorkedwithinGMMIportal - NewClaimprocessing - PaymentPostingandpaymentprocessing - OutreachClaimRequest - OverseasClaimprocessing - SubmittingTravelinsuranceclaims - Callcenter - Inform providers, policy holders on benefits and adjustments - Reimbursement/ClaimProcessing - ObtainingInvoice’sandverifyofauthorizations - WorkedwithinUHCportal - WorkedwithinGMMIportal - NewClaimprocessing - PaymentPostingandpaymentprocessing - OutreachClaimRequest - OverseasClaimprocessing - SubmittingTravelinsuranceclaims - Callcenter - Inform providers, policy holders on benefits and adjustments



Premier Eye Care

• United States
• Insurance
• 1 - 100 Employee

• HEDIS specialist

  • Apr 2022 - Dec 2022

  Risk Adjustment and chart review for multiple health insurance companies. Responsible for assisting in Coordination and indexing of outside records received via virtual E-fax • Monitor and update the correspondence logging system for all requests on a daily. • Schedule appointments, updates client personal information in HMS, updates medical history, pull and • file patient charts • Provide customer service to Ostomy and Catheter patients either in person or by telephone. • Greet and answers high volume telephone calls. • Performs check-in and check-out process for all clients. Show less



Change Healthcare

• United States
• IT Services and IT Consulting
• 700 & Above Employee

• Medical Insurance Biller

  • Sep 2020 - Apr 2022

  - Assembles, analyzes and audits, discharged charts and maintains an organized system for staff notification. - Plan,develop,maintainandoperateavarietyofhealthrecord indexes or storage and retrieval systems. - Correctbillingforchartsanddiagnosiscodes - Enterdatasuchasdemographiccharacteristics,historyandextent of diseases, and treatment into various databases. - Identify,compile,billandcodespatientdatausingstandard classification systems. - DMEdiagnosiscodingandmore - ClaimAdjustments/ClaimsAdjudication - CodeandclassifypatientChartsforinsuranceandhealthplans. - RiskAdjustmentManagementoffiles - Transcribesmedicalreports. - Resolvesorclarifiesmedicalrecordswithconflicting,missingor unclear information. - Prepares statistical reports, narrative reports as requested by HIM manager Show less



Ciox Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Medical Records Coordinator

  • Apr 2017 - Aug 2019

  • Working with supervisors to update policies and procedures • Imagine Processing • Burned digital images and prepared patient reports for patients, doctors, and attorney's office • Responsible for overseeing the proper maintenance of digital x-rays and cd-ROM via mail • Monitored mammography films by processing HIPPA-compliant authorization forms and sending patients' films to various facilities • Trained several new employees on company policies and procedures, to ensure smooth onboarding. Show less



Florida Spine Specialists

• United States
• Medical Practices
• 1 - 100 Employee

• Human Resources Administrative Assistant

  • Feb 2016 - Jul 2017

  Performed secretarial and administrative support services. • Scheduled and confirmed patient’s surgical procedures, diagnostic testing and medical consultations. • Verified insurance information and obtained referral/authorization • Training in Medi-tech • answered multiple phone lines and triaged calls. • Ordered and stocked office supplies • Performed medical record abstraction and entered findings into abstraction systems. Performed secretarial and administrative support services. • Scheduled and confirmed patient’s surgical procedures, diagnostic testing and medical consultations. • Verified insurance information and obtained referral/authorization • Training in Medi-tech • answered multiple phone lines and triaged calls. • Ordered and stocked office supplies • Performed medical record abstraction and entered findings into abstraction systems.



Broward Health

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Medical Billing Specialist

  • Apr 2014 - Jan 2017

  • Manage clinic schedule and collect balances from patients prior to appointment when appropriate, educate patients on payment expectations and arrangements. • Train new employee BH staff for all phases of patient processing. • File and retrieve medical records, and obtain insurance authorizations while maintaining patient confidentiality in concordance with HIPAA guidelines. • Manage clinic schedule and collect balances from patients prior to appointment when appropriate, educate patients on payment expectations and arrangements. • Train new employee BH staff for all phases of patient processing. • File and retrieve medical records, and obtain insurance authorizations while maintaining patient confidentiality in concordance with HIPAA guidelines.