Debora Jimenez
Reston
Summary
Detail-oriented Financial Services professional with experience in healthcare revenue cycle operations and customer service. Led resolution of complex account issues, ensured regulatory compliance, and drove accuracy in billing processes. Supported team performance and improved workflows while promoting accountability and operational efficiency. Aiming to leverage leadership skills and healthcare financial expertise to enhance patient-focused care.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Financial Services Representative IV
Inova
Fairfax, VA
12.2023 - Current
- Assumed responsibilities during leadership absence, guiding team members to resolve account issues effectively.
- Resolves complex account issues independently or by coordinating cross-functional efforts, escalating to leadership when appropriate.
- Analyzed and managed claim denials, developing effective appeal strategies to secure reimbursement and drive timely resolution.
- Communicated with payers to resolve denied claims and submitted detailed appeal letters for both government and commercial insurance.
- Utilized payer portals to verify eligibility, authorizations, and claim status, improving efficiency and reducing rework.
- Consistently met and exceeded departmental productivity and quality standards, contributing to the achievement of operational goals.
- Identified denial trends, supporting process improvements that enhanced quality and operational performance.
Financial Specialist II
Inova
Fairfax, VA
02.2013 - 12.2023
- Verified insurance eligibility, benefits, and authorization requirements prior to services to minimize denials and optimize revenue cycle performance.
- Accurately collected and updated patient demographic and insurance information to support proper billing and reimbursement.
- Managed daily work queue of accounts, prioritizing and processing tasks to support timely resolution.
- Achieved 100% accuracy in HAR verification and consistently exceeded quality assurance standards.
- Registered patients, ensured financial clearance, and collected payments at point of service, enhancing accuracy and improving patient experience.
- Delivered exceptional customer service by building professional and empathetic relationships with patients, providers, and interdisciplinary teams.
- Ensured compliance with HIPAA regulations by safeguarding patient information and maintaining confidentiality.
Customer Service Sales Agent Team Leader
Clear
Dulles, VA
04.2008 - 06.2009
- Drove membership enrollments by actively engaging travelers, educating them on CLEAR benefits, and supporting team members in achieving enrollment goals.
- Balanced high-volume operations with a strong focus on delivering exceptional customer and member experiences.
- Responded to 60+ daily customer inquiries, delivering timely, accurate, and professional service.
- Collected customer information, biometric data, and payments to ensure secure, seamless enrollment experience.
Product Flow Coordinator
Michaels Arts and Crafts
Fairfax, VA
07.2006 - 04.2008
- Prepared and fulfilled orders by accurately picking, packing, and labeling merchandise for shipment.
- Inspected incoming and outgoing shipments to ensure accuracy, quality, and compliance with company standards.
- Executed inventory control tasks, including cycle counts and stocking, to enhance merchandise organization and availability.
- Maintained up-to-date knowledge of sales promotions and store policies, supporting efficient operations and compliance with loss prevention practices.
- Processed cash and credit transactions, ensuring accurate handling and a positive customer checkout experience.
- Assisted customers with product inquiries, selections, and purchases, providing friendly and knowledgeable service.
- Consistently completed daily operational tasks with accuracy, efficiency, and attention to detail.
Education
High School Diploma -
South Lakes
RestonSkills
- Revenue cycle management
- Claims management
- HIPAA compliance
- Customer Service & Patient Account Resolution
- Data Analysis & Performance Monitoring
- Database Search and Data Entry Skills
- Strategic Financial Planning
- Critical thinking and analytical problem-solving
- Error identification
- Detail-oriented accuracy
- Time Management & Prioritization
- Leadership Support
Accomplishments
Inovas World of Difference Award
Certification
- Certified Spanish Interpreter, Inova
- CHAA, NAHAM, 2023
- Lean Six Sigma White Belt, 2024
- Project Management Essentials, 2024
Languages
Spanish
Native or Bilingual
Timeline
Financial Services Representative IV
Inova
12.2023 - Current
Financial Specialist II
Inova
02.2013 - 12.2023
Customer Service Sales Agent Team Leader
Clear
04.2008 - 06.2009
Product Flow Coordinator
Michaels Arts and Crafts
07.2006 - 04.2008
High School Diploma -
South Lakes