Bilingual (English/Spanish) Administrative Specialist eager to contribute solid background in health care toward supporting a progressive organization in optimizing bottom-line performance.

 

 

• Significant experience in driving cooperative efforts among major insurance carriers.
• Advanced knowledge of ADA, HIPAA, and OSHA requirements.

         Chosen and awarded as Employee of the Year out 13,000 personnel for Patient Satisfaction and Outstanding Customer Service. 

• Successful experience in directing full spectrum of clinic operations including staff leadership, billing, quality control, patient services and satisfaction, and facility maintenance.

         Well-versed in entire range of medical billing and claims processing procedures including CPT and ICD-9 coding.

         Impressive reputation for professionalism, integrity, commitment to confidentiality, and a team player work approach. 

        Industrious self-starter and multi-tasker with excellent knowledge of medical terminology.

        Considerable ability to process a high volume of work without sacrificing quality, and continuously seek out new ways to streamline administrative processes.   

 

 

Revenue Cycle Management Systems, Hollywood, FL, 2010 to Present

Appeals Representative

• Research, analyze and expeditiously process appeals of denied and underpaid hospital claims in precise alignment with productivity and collection goals.  
• Apply solid knowledge of managed care contracts and concepts toward successful resolving denial/appeals and accurately facilitating billing activities.
• Review and interpret EOBs, Remittance Advice, UB92, UB04, and HICFA 1500 data elements.

 

Nevada Health Centers, Inc., Las Vegas, NV, 2006 to 2009

Regional Operations Director

• Spearheaded daily multi-site operations inclusive of staff management, goal setting, employee development, and administration of numerous programs.
• Played an integral role in establishing and launching new clinic, and empowered, motivated and led Clinic Coordinators to exhibit productivity and performance excellence.

 

Continued

 

 

 

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Professional Experience continued

 

Nevada Health Centers, Inc., Las Vegas, NV, 2005 to 2006

Clinic Coordinator

• Directed, mentored and supervised clinical team in delivering patient care excellence by overseeing facility maintenance, administrative functions, quality management, and financial elements such as billing and procurement.  
• Effectively partnered with health care provider staff at clinics to ensure seamless operations and maintain unparalleled satisfaction levels.

 

Sharp-Rees Stealy Medical Group, San Diego, CA, 1995 to 2005

Pediatric Medical Assistant   

• Actively assisted physicians in performing broad range of medical procedures and contributed exemplary patient relations skills toward administering immunizations and injections, EKGs, catherizations, etc.
• Assessed/recorded patients vital signs, performed venipuncture, and meticulously maintained medical charts and records.
• Obtained authorization from insurance companies and oversaw extensive front office tasks such as receiving patients, obtaining personal insurance information, managing co-pays, and scheduling appointments.
• Trained, mentored and managed new employees and students.

 

 

Healthcare Administration degree (in progress)

University of Phoenix, Fort Lauderdale, FL

 

Certified/Registered Medical Assistant

Maric College of Medical Careers, San Diego, CA

 
CPR Certification