MAYRA ARGUETA
Warrenton
Overview
13
13
years of professional experience
Work History
FINANCIAL SPECIALIST 4
Inova Health System
05.2023 - Current
- Functioned as a Patient Financial Specialist IV, specializing in handling insurance reconsiderations and appeals for denied medical claims.
- Manage no-authorization denials, verify claim status, and submit formal appeals to secure reimbursement.
- Managed high-complexity, high-dollar accounts exceeding $45,000, achieving timely and accurate claim resolution.
- Communicate regularly with major payors including Johns Hopkins, the Veterans Administration, and various commercial insurance companies.
- Contacted physicians' offices and utilized EMR systems to efficiently retrieve and submit medical records for insurance payors.
- Facilitated electronic faxing, phone correspondence with insurance companies and patients, and collected additional information to support claims.
- Perform adjustments and write-offs when appeals are upheld or further action is not possible.
Oncology New Patient Coordinator
Inova Schar Cancer Institute Radiation Oncology Associates
03.2022 - 05.2023
- Request medical records such as films, medical history, radiation records.
- Schedule new patient appointments consults.
- Coordinated consult scheduling with RNs and MDs and managed appointments across departments.
- Verify eligibility of insurance for new patient consults.
- Delivered exceptional customer service as primary point of contact for patients scheduling appointments.
- Provide prior radiation records such as dicom and PDFs to the doctor and dosimetrist team.
- Follow hospital safety policy and compliance with our Joint Commission.
- Usage of epic and Aria system to schedule appointments provides customer assistance in any given situation.
PATIENT ACCESS REP 3 REHABILITATION
Inova Fairfax Hospital
09.2017 - 03.2022
- provides customer assistance in any given situation
- work with my team members and therapists to help in any problem solving that is needed
- collect payment at POS in outpatient setting
- collecting insurance information from patients and documenting it
- scheduling all outpatient rehabiliation appointments
- preforming service recovery when patient becomes upset regarding scheduling issues
- Communicates with doctor’s office to ensure of getting our patient’s order in time before appointments
- working together with my team and therapists in improving our department with scheduling
- working with financial department to relay the benefits too our patient’s
- assist patients who need to apply to the charity program
- In charge of scheduling NICU babies for Inova Follow Along program and explain our program
- train any new team members on scheduling and epic use
- Taking incoming admission calls and admitting our patient and also implying the patient safety of Patient ID before doing so
- registering patients in all of our surgery departments,obed triage,labor and delivery,c-section,GE lab,Cath lab…etc
- putting together patient’s schedule and provide directions for upcoming appointments
FRONT DESK RECEPTIONIST
Natural Horizons Wellness Center
03.2017 - 09.2017
- Answered incoming calls and returned calls to patients to ensure clear communication and timely responses.
- Collected payment liability and provided receipts for insurance reimbursement to facilitate patient billing processes.
- Scheduled appointments for both dental and medical in chemotherapy, holistic primary care.
- Input patient information to update accounts and filed records to maintain organized patient documentation.
SALE ASSOCIATE/VISUAL MERCH MANAGER
Forever 21
10.2013 - 02.2017
- establish greeting when customers came in the store
- Helped our customers in any requests they needed when it came to finding a size or type of clothing
- used POS system to collect payments and do returns
- stock the floor with product and style our weekly windows with newest merchandise that is out for season
- promote our current sales to our customer
- train our new members in and provided feedback on how too improve on
Education
Associate of General Studies - Science
Northern Virginia Comm College
05-2017
High School Diploma -
Westfield High School
01-2014
Skills
- Problem Solving
- Spanish speaking
- Epic EMR
- Word Document
- Client Relationship Building
- Aria software
- Medical Records requester
- Leadership
- Insurance appeals
- Claim management
Languages
Spanish
Limited
Timeline
FINANCIAL SPECIALIST 4
Inova Health System
05.2023 - Current
Oncology New Patient Coordinator
Inova Schar Cancer Institute Radiation Oncology Associates
03.2022 - 05.2023
PATIENT ACCESS REP 3 REHABILITATION
Inova Fairfax Hospital
09.2017 - 03.2022
FRONT DESK RECEPTIONIST
Natural Horizons Wellness Center
03.2017 - 09.2017
SALE ASSOCIATE/VISUAL MERCH MANAGER
Forever 21
10.2013 - 02.2017
Associate of General Studies - Science
Northern Virginia Comm College
High School Diploma -
Westfield High School