Melissa Vences

• Obtained client medical history, medication information, symptoms, and allergies.
• Sanitized, restocked, and organized exam rooms and medical equipment.
• Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
• Performed medical records management, including filing, organizing and scanning documents.
• Built strong relationships with patients through effective communication skills that foster trust in the clinic''s commitment to quality care.
• Maintained a safe and clean clinical environment by adhering to infection control guidelines and disposing of biohazardous waste properly.
• Facilitated seamless patient care with thorough and accurate documentation of medical histories, vital signs, and medications.
• Assisted physicians with minor surgeries, including preparing operating room and sterilizing instruments.
• Ensured patient safety and comfort during examinations, effectively addressing concerns and answering questions.
• Performed phlebotomy tasks efficiently while ensuring minimal discomfort for patients during blood collection procedures.
• Enhanced clinic efficiency by assisting physicians with routine procedures and diagnostic tests.
• Coordinated patient referrals to specialists or other healthcare providers as needed for comprehensive care management plans.
• Assisted in the development of clinic policies and procedures to ensure compliance with industry standards and regulations.
• Maintained inventory of medical supplies, ensuring availability for all procedures and treatments.
• Performed EKGs and other diagnostic tests, contributing to accurate and timely diagnoses.
• Contributed to clean and safe clinic environment by adhering to sanitation protocols.
• Administered medications and injections as prescribed, adhering strictly to protocols for patient safety.
• Answered telephone calls to offer office information, answer questions, and direct calls to staff.
• Collected and documented patient medical information such as blood pressure and weight.
• Completed EKGs and other tests based on patient presentation in office.

• Maintained consistent follow-up on status of prior authorization requests.
• Submitted for prior authorization with required documentation to appropriate funding source.
• Reviewed documentation for accuracy and assessment of necessity.
• Reviewed authorizations from payer to determine approved or denied items.
• Calculated estimated copay based on current insurance benefits.

· Maintained a safe, clean working environment, including unit based safety and infection control requirements.

· Responsible for verifying insurance coverage, eligibility, benefits, obtaining authorizations and pre-certs as required by the individual insurance company.

· Processes all information required to complete referrals prioritizing by level of urgency and patient need.

· Accurately enter notes regarding letters or correspondence from insurance companies regarding insurance authorization or other notifications.

· Adheres to all medical practice policies and procedures.

· Inform patients of referral status.

· Answers telephone inquiries on status of referral.

· Performs other duties as necessary.

• Communicated with insurance providers to resolve denied claims and resubmitted.
• Collected payments and applied to patient accounts.
• Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
• Posted payments and collections on regular basis.
• Delivered timely and accurate charge submissions.
• Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
• Responded to customer concerns and questions on daily basis.
• Audited and corrected billing and posting documents for accuracy.
• Handled account payments and provided information regarding outstanding balances.
• Generated accounts payable reports for management review to aid in financial and business decision making.
• Communicated with insurance providers to resolve denied claims and resubmitted
• Collected payments and applied to patient accounts
• Verified insurance of patients to determine eligibility

• Coached team members in techniques necessary to complete job tasks.
• Worked different stations to provide optimal coverage and meet production goals.
• Trained new team members by relaying information on company procedures and safety requirements.
• Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills.
• Audited team performance and compliance with insurance and Policy standards.
• Established open and professional relationships with team members to achieve quick resolutions for various issues.
• Held weekly team meetings to inform team members on company news and updates.
• Maintained database systems to track and analyze operational data.
• Developed monthly and daily production output plans to deliver on customer service and financial metrics.
• Responded quickly and calmly to emergency situations, providing life-saving measures when necessary

• Maintained consistent follow-up on status of prior authorization requests.
• Submitted for prior authorization with required documentation to appropriate funding source.
• Reviewed documentation for accuracy and assessment of necessity.
• Reviewed authorizations from payer to determine approved or denied items.
• Calculated estimated copay based on current insurance benefits.
• Maintained files and controlled records to show correspondence activities.
• Managed time efficiently in order to complete all tasks within deadlines.
• Worked well in team setting, providing support and guidance.
• Proven ability to learn quickly and adapt to new situations.
• Presented clear and concise explanations of governing rules and regulations.