Lourdes A. Borja
American Canyon
Summary
I take pride in my strong work ethic, consistently demonstrating reliability and a commitment to learning and adapting new skills in the healthcare industry.
Overview
33
33
years of professional experience
Work History
FACILITIES MAIL & LOGISTICS SITE OPERATIONS
JONES LANG LASALLE/GOOGLE
10.2022 - Current
- Provide customer support and assistance throughout the shipping process.
- Respond to and follow up on tickets with clients regarding mail and package tracking.
- Meet or exceed performance indicators and provide clients with email updates on their packages.
EXPERIENCED WAREHOUSE ASSOCIATE
STITCH FIX
01.2017 - Current
- Processing and quality control incoming returned items from clients.
- Bin returned apparel and accessories back into inventory.
- Create new tags for any returned item without any labels.
MEDICAL CLAIMS EXAMINER
COMPANY
01.2008 - 01.2013
- Maintained a minimum of 300 claims processed on a weekly basis with 98% processing accuracy.
- Acquired in depth knowledge of medical claims by processing various types of healthcare policies, such HMO, PPO, POS and INDEMNITY policy plans such ICD, CPT, HCPCS, and CDT coding.
- Knowledge of regulatory Standards in claims submission (paper and /or electronic) ability to work independently, prioritize and handle volumes of work.
- Ensures claims files are properly documented and claims coding is correct.
- Reviewing and processing information requests, preparing new patient charts, file maintenance and other duties related to maintaining patient records.
- Other duties/responsibilities as assigned.
CLEAICAL ASSISTANT
GREAT WEST LIFE
01.2005 - 01.2008
- Sorted, filed, and tabulated various documents and records.
- Trained temporary employees and operated scanning hardware and software.
OFFICE ASSISTANT
DRSEDNER RCM GLOBAL INVESTORS
01.1996 - 01.2002
- Perform a variety of routine clerical duties such as processing documents and records.
- Extracting and compiling records for data systems.
- Responding to routine inquiries concerning office/ department services and procedures.
- Maintaining and monitoring established record keeping and filing with database systems, and producing forms, letters, record entries and other material.
MAILROOM SERVISOR
ARCHER MGMT SERVICES
01.1993 - 01.1996
- Maintained individual production and attendance records.
- Provided immediate supervision to a unit or group and assigned tasks.
Skills
- Over 8 years of experience in the healthcare industry as a Medical Claims Examiner
- Familiar with service center processes related to medical healthcare policies
- Ability to prioritize and handle volumes of work independently
- Expertise in handling claim issues for insurance companies, including Great West Life and Cigna
- Knowledge of regulatory standards in claims submission
- Experience in maintaining accurate records and documentation
EDUCATION
- CAREER PLANNING CERTIFICATE | 2005 | NORTH EAST CAREER, SAN FRANCISCO
- BUSINESS/COMPUTER SKILLS CERTIFICATE | 1994 | CITY COLLEGE OF SAN FRANCISCO
- BUSINESS/TYPING CERTIFICATE | 1990 | CITY COLLEGE OF SAN FRANCISCO
Timeline
FACILITIES MAIL & LOGISTICS SITE OPERATIONS
JONES LANG LASALLE/GOOGLE
10.2022 - Current
EXPERIENCED WAREHOUSE ASSOCIATE
STITCH FIX
01.2017 - Current
MEDICAL CLAIMS EXAMINER
COMPANY
01.2008 - 01.2013
CLEAICAL ASSISTANT
GREAT WEST LIFE
01.2005 - 01.2008
OFFICE ASSISTANT
DRSEDNER RCM GLOBAL INVESTORS
01.1996 - 01.2002
MAILROOM SERVISOR
ARCHER MGMT SERVICES
01.1993 - 01.1996