Daniel R. Gallegos II

abllud@r.postjobfree.com

Cell 206-***-****

Home – 206-***-****

Skills and Related Experience:

• MS Office Word, Excel, Access, Power Point, Outlook Ability to learn new software

• Type 50 wpm Read & interpret medical insurance contractual language

• 10 Key by touch 450 kspm Analyze loss trends and patterns

• Proficient in Communication Oral and Written

Data Entry

• Experienced Customer Service Knowledge of Medical Terminology

• Work in a team environment and independently Knowledge of CPT 4 & ICD9 Diagnosis coding

Summary of Qualifications:

Dually talented Financial Analyst and Healthcare Coordinator.

As an experienced Financial Analyst I can develop, interpret, and implement moderately complex financial and

accounting concepts or techniques for financial planning and control.

Present financial data and analysis for miscellaneous internal and external reporting.

A seasoned Healthcare Claims Examiner and Health Services Specialist, that examines implements moderate and

complex medical benefits of health plans for financial reimbursement of medical claims.

Experience:

11/2004 – 02/2010 Virginia Mason Medical Center Seattle, Washington

Using MS Office products performed research, and analysis to provide management with financial data.

Advanced in MS Excel, Sum, If/Or Statements, Pivot Tables, Filtering, Vlookups formula’s.

Analyzed any loss, trends, and reported selected data for variances of under paid facility claims.

Coordinates with all levels of management and outside clients to summarize and report variances.

Supply financial analysis and recommendations for policy and procedural changes.

Communicate with outside clients and request revenue for under paid claims

Evaluates financial alternatives and recommends appropriate action.

Apply corporate financial policies, government legislation, and accounting theory as directed.

Assure compliance with all federal, state, and other third party regulations and requirements.

Serve as resource to respond to complex questions from others within the medical center.

Use data or maintains database(s) to track information.

04/1989 – 02/2002 CIGNA HealthCare Visalia, CA & Seattle, WA.

Customer Service Representative, answering phones for medically insured members and healthcare providers.

Communicate skillfully insurance benefits and analyze data to determine payment of insurance claims submitted

by the physicians and medical facilities.

Additional training and promoted to Health Services in Seattle in 1996 – 2003 to review procedures and policies

to authorize specialty physician visits and surgical authorization and Inpatient Hospital confinements, according

to members’ contract and benefits.

Education:

Highline Community College: 06/2002 – 05/2004

Computer Programmer: Local Area Networking, installing NT Server 4.o and Window 2000.

MS Office Word, Excel, Power Point, Outlook, Visio 2003.

Data structures, methodologies and flow diagrams in Systems Development Life Cycles.

Introduction to Java developing applications using array s, loops, nested loops.

Beginning in C++ applications in a 3 dimensional arrays, functions and classes.

Project Management with systems analysis and delivering time management solutions.

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