Detail oriented quality focused Medical Records professional, with extensive experience in developing and maintaining a variety of health records and electronic claims filing. Familiar with Third Party Insurance, Medicare, Next Gen, EPM, EMR software, with strong legal, ethical, and medical knowledge. Dedicated to maintaining strict patient confidentiality. A team player with effective interpersonal and communication skills, adept at building productive relationships and building rapport with a diverse set of individuals.
Electronic Medical Record (EMR) software
Fluent on the usage of Medical Software Next Gen and EPM.
Records Organization & Management.
ICD-9, CPT-10,ICD-10 & Medical Terminology. MS Office Suite: Word, Excel, Access, and Outlook
Hospital switchboard multi-line phone, paging, and announcement system
Authorizations Representative Department Clerk01/2013 to 12/2015Preferred Medical PlanCoral Gables, Fl
Preferred Medical Plan.
4950 sw 8th street Located at Coral Gables and currently serving the Miami-Dade community, preferred medical plan are the oldest independently owned HMO in South Florida.
specialize in providing healthcare coverage to working individuals and families who do not receive employer-sponsored health bbenefits.
Authorization Representative Department
Answer calls from physicians offices, hospitals and patients using exemplary costumer service skills
Accurately enter required information (non-clinical and structured clinical data ) into computer database.
Review structured clinical data matching it against specified medical terms and diagnoses or procedures codes ( without the need for interpretation) and follow established procedures for authorizing request for further review.
Call back providers with precertification numbers as needed and file completed precertification request as per established procedures.
Call hospitals for discharge dates as needed.
Reefer callers to benefit departments of correct claims administrator when requesting enefit information.
Print and sent form letters from ICARE system as directed.
Maintain patient confidentiality as defined by state, federal and company regulations.
Establish effective rapport with other employees, professional support service staff, costumers, clients, patients, families and physicians.
Actively support departmental and corporate strategic plans and ensure successful implementation.
Maintain cooperative working relationships with all ICM departments and providers.
Support company and departmental QA/QI initiatives.
Administrative Assistant06/2012 to 12/2015All Car Suspension LLC Online CompanyMiami, Florida
Served as central point of contact for all outside vendors needing to gain access to the Company.Designed electronic file systems and maintained electronic and paper files.
Managed Accounts Payable and Receivable.
Dispersed incoming mail to correct recipients.Made copies, sent faxes and handled all incoming and outgoing correspondence.Organized files, developed spreadsheets, faxed reports and scanned documents.
Clerk02/2011 to 05/2013Leon Medical CentersMiami, Fl
Leon Medical Centers has been recognized as one of the top four medical institutions in the nation and it has earned numerous awards for its medical excellence.
Provided clerical/administrative support in the Referral Management Center for customer service, referral tracking, referral appointing, and reporting activities.
Supported the daily functions of specialty care referral appointing, referral review and coordination, beneficiary counseling and referral tracking.
Medical Records Clerk06/2009 to 02/2011Leon Medical CentersMiami, FL
Answer telephone, relay messages and transfer calls as appropriate.
File loose documentation generated from inside and outside institutions, such as: laboratory reports, radiology results, completed consultation reports, progress notes, etc., using EMR format.
Maintain system and update Facility health status requirements for inmate physical, laboratory, PPD, etc.Managed switchboard operations involving all inbound & outbound calls.
Screened calls and routed callers to the appropriate department.
Photocopied and scanned records and documents for billing and/or legal services.
Maintained confidentiality of medical records and information.
Physician Referral Department
Medical Assistant Technician2009Florida Career CollegeMiami, Florida
Fluent in both Spanish and English
HTMS ICD-10- Clinical and Data Analytical Program, through the Eden University Learning Program with a Certificate of Completition successfully completed.
Accounts Payable and Receivable, administrative support, Alpha, benefits, billing, central point of contact, clerical, consultation, Coral, counseling, CPT, Customer Service, Data Entry, documentation, English, faxes, ICD-9, legal, notes, Medical Terminology, Access, Excel, mail, MS Office Suite, Outlook, Word, Next, progress, radiology, reporting, Fluent in Spanish, Spanish, spreadsheets, switchboard, Team player, Technician, telephone, phone, Typing