Rafael Carrasquillo
IMA Medical Group
White Bear Lake
2
Languages
1
Certification
7
years of professional experience
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience.
Work History
Medical Biller
8 Months- Completed appeals and filed and submitted claims.
- Completed appeals and submitted claims to ensure timely reimbursements.
- Utilized medical billing software to track and manage denied claims efficiently.
- Reconciled codes against services rendered.
- Investigated discrepancies in medical billing and coding to identify errors or irregularities.
- Maintained up-to-date knowledge of coding systems such as ICD 10 and CPT codes used in medical billing processes.
- Trained other staff members in medical billing processes and procedures.
- Utilized medical billing software to effectively track and manage denied claims, improving resolution rates.
- Conducted regular audits of medical billing activities to identify and rectify errors or discrepancies.
Chart Retrieval Specialist
1 Year 2 Months- Reviewed medical records to ensure accuracy and completeness.
- Collected, filed, scanned, and retrieved confidential patient information to ensure accessibility and compliance.
- Maintained accurate documentation of all medical record activities to support regulatory adherence and quality assurance.
- Documented patient histories in accordance with established standards.
- Maintained electronic medical records for all clients
- Verified record copies to ensure accuracy and completeness before distribution.
- Scanned and validated medical records for upload.
- Retrieved medical charts for healthcare staff for filing in medical records.
- Traveled to different clinical sites to review procedures.
Medical Records Team Lead
4 Years 10 Months- Organized patient charts, gathering medical histories, lab results and consents.
- Safeguarded patient records, managing data transfers in compliance with HIPAA standards and organizational regulations.
- Managed release of information requests and identified requestors as patient, relation or provider.
- Tracked and processed release of information requests.
- Processed and invoiced records requests from patients, providers and third parties.
- Managed release of information requests, ensuring accurate identification of requestors as patients, relations, or providers to uphold compliance.
- Supported administration staff with records requests to support patient care.
- Tracked and processed release of information requests, maintaining organized records for timely access to patient information.
- Maintained complete confidentiality in accordance with organization and legal requirements.
- Processed and invoiced records requests from patients, providers, and third parties, contributing to streamlined operations.
- Obtained information by contacting appropriate personnel or patients.
- Transmitted information or documents to customers through email, mailings or facsimile machine.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Mentored junior team members and managed employee relationships.
- Facilitated HEDIS data collection for performance improvement
Medical Biller and Coder
7 Months- Reviewed medical records to ensure compliance with insurance company requirements.
- Reviewed and verified received payments for accuracy, applying them to correct patient accounts.
- Reviewed received payments for accuracy and applied to intended patient accounts.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
- Assigned additional diagnosis codes based on clinical findings from laboratory and radiology reports.
- Communicated with healthcare personnel and practitioners to ensure accurate coding and billing.
- Maintained updated knowledge of coding requirements, which included continuing education and certification renewal.
- Compiled and maintained logs, and statistical or research records to locate requested health data.
- Maintained high accuracy rate on daily production of completed reviews.
Telemarketer
6 Months- Identified potential customers through cold calling and targeted database research to expand lead pool.
- Cultivated customer relationships to enhance sales opportunities and drive repeat business.
- Created positive first impressions with customers on calls.
- Provided product information, answered questions, and offered solutions to customer inquiries.
- Greeted customers in a friendly, professional manner on the phone.
- Maintained up-to-date knowledge of company products and services.
- Worked closely with marketing teams to develop effective strategies for increasing customer base.
- Followed up with existing customers to recommend additional products or services aligned with their needs.
Call Center Representative
5 Months- Answered, screened and processed high volume of calls daily with call management system and web-based communications.
- Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer.
- Maintained call control and efficiently navigated scripts to address customer issues and enhance service delivery.
- Engaged with callers, confirming or clarifying information to effectively diffuse anger and improve customer satisfaction.
- Delivered fast, friendly and knowledgeable service for routine questions and service complaints.
- Resolved customer inquiries, questions and concerns to consistently offer quality service and meet performance benchmarks.
- Met or exceeded call speed, accuracy and volume benchmarks on consistent basis.
- Offered resolutions to de-escalate calls and solve customer issues.
- Consistently reached and exceeded benchmarks call speed, accuracy and volume benchmarks on consistent basis.
- Provided resolutions to de-escalate calls, effectively addressing customer issues and fostering positive interactions.
- Helped customers with inquiries with inquiries and transactions to meet productivity goals and achieve profit growth.
- Received and recorded customer payments or payments and arranged for billing.
- Presented existing and prospective customers with valuable service or product information to aid in decision-making.
Appeals Specialist
10 Months- Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions.
- Monitored claims reports to identify issues and collaborated with adjusters for timely resolutions.
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Reviewed documentation for coding accuracy, identifying and correcting errors to ensure compliance.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Examined claims, records and procedures to grant approval of coverage.
- Prepared and verified insurance-claim forms and related documents for accuracy and completeness.
Education
BBA - Criminal Justice
High School Diploma
Skills
EMR systems
Software applications
Insurance billing processes
Claims processing
Coding compliance
Medical billing processes
Electronic claims processing
Customer support
Software: Zoho
Avatar
Adobe Pro
Microsoft Office
Teams
Ring Central
Healow
Vidistar
Certification
- Foundation of Project Management - 2023
- Foundation of Data, Data, - 2023
- Medical Billing and Coding Essentials - 2024
Languages
Spanish
Native/ Bilingual
English
Full Professional
Timeline
Medical Biller
IMA Medical Group
11.2024 - 07.2025Read More
Chart Retrieval Specialist
Episource
12.2023 - 02.2025Read More
Medical Biller and Coder
Heart and Life Community Center
06.2022 - 01.2023Read More
Medical Records Team Lead
IMA Medical Group
01.2020 - 11.2024Read More
Telemarketer
IMA Medical Group
07.2019 - 01.2020Read More
Call Center Representative
Quality Marketing Group
02.2019 - 07.2019Read More
Appeals Specialist
Angels for Kids on Call
04.2018 - 02.2019Read More
Instituto Cumbre
High School Diploma
Read More
Inter American University of Puerto Rico Ponce
BBA from Criminal Justice
Read More