Desiree Pacheco
Phoenix
Summary
Dedicated claims and customer service professional with strong data entry accuracy, insurance knowledge, and high-volume processing experience. Skilled in resolving claim issues, updating records, verifying insurance eligibility, and providing high-quality customer support. Known for fast, accurate typing, strong attention to detail, and maintaining compliance with HIPAA and payer policies. Reliable team player with expertise in HIPAA regulations and customer service.
Overview
10
10
years of professional experience
Work History
Medical Claims Specialist
Mercy Care (Aetna)
04.2020 - Current
- Process high-volume Medicaid/AHCCCS claims with 99% accuracy.
- Perform detailed data entry of diagnosis codes, demographics, and eligibility updates.
- Resolve claim discrepancies by reviewing documentation and contacting providers.
- Maintain HIPAA compliance and protect patient data across all systems.
- Support prior authorizations by gathering information and updating provider records.
- Achieved 98% customer satisfaction based on post-interaction surveys.
- Train new hires on claims systems, workflows, and data entry accuracy.
Service Expert Specialist
Modivcare Solutions
08.2015 - 05.2021
- Completed high-volume data entry updates in EMR/SQL systems for billing and claims information.
- Provided customer service to patients regarding benefits, billing, and claim status.
- Resolved claim issues by researching records and coordinating with internal teams.
- Ensured payer policy compliance and accurate documentation for claim processing.
- Protected patient information through consistent HIPAA adherence.
Education
High School Diploma -
Genesis Academy
Phoenix, AZ05-2009
Medical Billing And Coding Certificate - MBC
Allied Health of Arizona
Glendale05-2025
Skills
- Data Entry (High Accuracy & Speed)
- Claims Processing & Research
- Customer Service & Call Handling
- Insurance Verification & Eligibility
- Medicaid, Medicare & Commercial Payers
- ICD-10 & CPT Familiarity
- EMR/SQL Systems
- HIPAA Compliance
- ICD-10 proficiency
- Claims processing
- Insurance verification
Timeline
Medical Claims Specialist
Mercy Care (Aetna)
04.2020 - Current
Service Expert Specialist
Modivcare Solutions
08.2015 - 05.2021
High School Diploma -
Genesis Academy
Medical Billing And Coding Certificate - MBC
Allied Health of Arizona