Ilys Quijano

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Lien Negotiator (Personal Injury Law Firm)

Sweet James Law Firm

Apr 2024 - Apr 2025 (1 year 1 month)

As a Lien Negotiator at a Personal Injury Law Firm, I was responsible for assembling, organizing, and reviewing client medical bills and records specifically related to lien claims. I negotiated lien reductions with healthcare providers, insurance adjusters, and attorneys, while drafting and sending lien reduction acceptance and disbursement letters. I developed and implemented strategies to expedite the settlement of liens, maintaining thorough communication with all stakeholders, including clients, healthcare providers, and insurance representatives. Additionally, I performed essential administrative tasks to support case management and ensure the smooth operation of the liens team. My role also involved utilizing SOAP documentation techn

AR Medical Claims Analyst

Med-Metrix

Dec 2022 - Apr 2024 (1 year 5 months)

As an AR Medical Claims Analyst, I am responsible for reviewing claim forms to ensure the accuracy of procedures, diagnoses, demographic and insurance information, as well as all other relevant fields. I create clinical, technical, and administrative appeals and reconsiderations to support claims, leveraging my expertise in medical billing, data entry, medical coding, and medical terminology. Additionally, I manage documentation effectively to streamline processes. My familiarity with Payer Portals, including Availity, UHC portal, State Medicaid, and Medicare, enhances my ability to navigate complex claims environments. Furthermore, I utilize SOAP documentation techniques to review medical records thoroughly, which aids in making outbound c

Medical Claims Analyst (CSR)

GeBBS Healthcare Solutions

Mar 2022 - Dec 2022 (10 months)

Accept inbound calls from members and patients that need assistance with their medical billing inquiries. Understanding of payments and claims related to office and hospital visits and medical procedures and thoroughly explaining how customer benefits are applied to costs associated with these visits and procedures.

Customer Care Representative (CSR)

ONE Contact Center

Feb 2021 - Feb 2022 (1 year 1 month)

Accept inbound calls from Medicare members that need assistance with their Medicare Benefits. Offers Medicare Part C Coverage to Medicare members availing the plan.

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