Joanna Dela Cruz

JOANNA DELA CRUZ BENEFITS AND CLAIMS COORDINATOR PROFILE WORK EXPERIENCE I've worked as Customer Service for Healthcare Insurance for almost 7 years. I have experience with verification of Benefits, Authorization and checking of Claims Denial. Horizon Blue Cross Blue Shield of New Jersey – Alorica Customer Service Representative 2013 - 2014 • Gives-out information to physicians from United States regarding their patients’ health insurance benefits, enrollment and miscellaneous information, all of which are in accordance with HIPAA Law, which establishes privacy and security standards for the Health Care system. • Evaluated, investigated and medical insurance claim payments; and adjusted claims that were incorrectly processed. Team Manager 2014 - 2020 • Mentoring employees through call monitoring, spot coaching, setting expectations, analyzing and managing performance. Motivates performance and administers recognition programs. My recent job was Benefits and Claims Coordinator - verification of benefits for variety of providers and authorization request. I also handled checking and making follow up on denied claims (aged claims) to have it paid which I know is one of my edge for the job opening. I'm also willing to learn & improve my qualification for such great benefit. EMAIL:-LOCATION: • Philippines SKILLS: • Highly motivated to expand knowledge and skills. • Results-oriented, responsible, trustworthy, hardworking and efficient. • Able to work under pressure with minimal supervision. • Knowledgeable of HIPAA privacy and security practices. • Effective communication skills for phone contacts with insurance payers to resolve issues • Proficient in using EHR like Simple Practice, Practice Fusion, Therapynotes, Theranest, ect. EDUCATION: Completed Bachelor of Science in Nursing APS Medical Billing Benefits and Claims Coordinator 2012 – 2013 and 2020 - 2021 • Contact the Health Insurance companies to verify patient's eligibility, benefits, authorization and claims for a variety of Healthcare providers. • Complete interactive form with the detailed and correct patient's benefits. Contact Health Insurance companies to check claims status and follow-up denied claims to verify if it's process correctly or if it can be reprocessed and paid. • Registering New Patients in the Electronic Medical Record System Ahvair Medical Billing Account Coordinator 2020 - 2021 • Contact the Health Insurance companies to verify patient's eligibility, benefits, authorization and claims for a variety of Healthcare providers. • Complete interactive form with the detailed and correct patient's benefits. Contact Health Insurance companies to check claims status and follow-up denied claims to verify if it's process correctly or if it can be reprocessed and paid. • Submit claims and post payments through EHR (Practice Fusion, Therapynotes, Theranest & Sharenote). • Registering New Patients in the Electronic Medical Record System.