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Summary

Highly dedicated, motivated, outgoing with excellent customer and problem solving skills. currently seeking a position with a company where I will able to utilize my experience as a Health Care Administration professional with my background in Medicare,  insurance verification, Long Term Care, DME, Complex Rehabilitation, Complex Medical Equipment, Orthotic and Prosthetics. 

Skills and Expertise

  • Fully Bilingual (Spanish/English)
  • Medical Terminology
  • Insurance Verification and Eligibility
  • Medicare / Medicaid
  • Durable and Home Medical Equipment
  • Pharmacy Terminology
  • Healthcare Management
  • Medical Records
  • Communication Skills
  • Microsoft Office (Excel, Outlook, Word)

Work experience

05/2016Present

Provider Relations Assistant

Risk Management Services - Walt Disney World Parks & Resorts, Kissimmee, FL
  • Assist Provider Relations and Workers' Compensation team with medical provider credentialing.
  • Monitored and assisted with the management of the Pharmacy Desk with prior authorization requests for medications related to worker’s compensation claims.
  • Assisted with bill review and payment tracking to ensure bills received were related to the claim and providers were properly reimbursed in a timely manner. 
07/201506/2016

DME Customer Service Representative

Ambassador Ancillary Services - Consulate Health Care, Maitland, FL
  • Responsible for Ordering DME products and supplies for long term care facility residents, which included, but not limited to: Urological, Colostomy, Wound Care and Enteral Nutrition formulas.
  • Reviewed patient charts to ensure medical necessity was met and confirmed the product being ordered was the correct one based on the diagnosis.
  • Managed patient records in adherence  with company policy and Medicare guidelines.
04/201406/2015

DME Care Coordinator (Worker's Compensation)

SMS National, Altamonte Springs, FL
  • Responsible for coordinating in an expedited manner the Durable and Home Medical Equipment, Custom Orthotics & Prosthetic appliances, Manual and Custom mobility and other services.
  • Schedule claimant’s appointments for services
  • Knowledge of Medicare DMEPOS/HCPCS rules and regulations regarding dispensing, billing guidelines and payment rules.
  • Adhere and comply with carrier's contracts, terms, rules and/or policies and procedures to maximize cost savings while expediting the process.
09/201305/2014

Member Services, Medicare Plan New Enrollment Intake

BroadPath Healthcare Solutions, Work At Home
  • Provide excellent customer service to potential members calling with inquiries about services, plan coverage, plan availability, cost and other information.
  • Scheduling meetings or seminar reservations between potential members and sales agents.
  • Responsible for new member enrollment intake and data entry.
09/201209/2013

Patient Coordinator

South Park Chiropractic, Orlando, FL
  • Provide excellent customer service to patients calling with inquiries about services, scheduling and other information.
  • Responsible for new patient intake, data entry, scheduling already established patients and following up with missed appointments all while maintaining office flow.
  • Insurance verification, collecting co-payments and payments for services and products at the time of service.

Education

20122014

Healthcare Innovation, General Health

Duke University, Online

Continuing Education

20092010

Pharmacy Technician - Technical Diploma

Everest University, Orlando, FL

Graduated, Technical Diploma in General Pharmacy Technician Studies