RESUME OF CHARMAINE AQUINO

Phone: 510-***-**** Email: acgczk@r.postjobfree.com

Accomplished in relating to and working with individuals of wide diversity

in personalities, ethnic origins, lifestyles, cultural orientation, ages,

and levels of education, technical training and awareness.

PROFILE OF QUALIFICATIONS

1. Perceptive, objective and analytical. Thorough and accurate. Well

organized. Detail and results oriented.

2. Possess exceptional knowledge, aptitude, competency in analytical,

organizational and customer service skills..

3. Possess exceptional communication skills in both written and oral

expression. An effective listener.

4. Innovative, adaptable and open-minded. Adept in devising effective

solutions beyond the conventional.

5. A cooperative and constructive team player. Patient, tactful and

diplomatic.

6. Substantial knowledge in Medicare, Medi-Cal billing, Medical

Terminology, ICD-9, CPT coding, CMS 1500, UB04 coding and forms.

7. Knowledgeable in Microsoft Office Suite (MS Word, Excel, Access, Power

Point)

PROFESSIONAL EXPERIENCE/WORKING EXPERIENCE

2012-2014 Full-time Parent/Caregiver for an ill adult

Currently getting certification in Medical Billing

and Coding.

NATIVE AMERICAN HEALTH CENTER, Oakland, CA.

Patient Account Representative

2012

8. Successfully raised departmental productivity goal to 85% by billing

Medicare claims electronically and surpassed the weekly goal on the

claims backlog.

9. Received a commendation for accurately entering all encounter

information into NextGen within 48 hours of the patient visit.

10. Interfaced with Insurance administrators, physician offices, patients

and internal personnel.

11. Developed strategies for efficiently posting payments for Medicare,

Medi-Cal, insurance carriers and patients.

DELTA DENTAL OF CA. Rancho Cordova, CA.

Dental Auditor

2010-2011

12. Received numerous awards for meeting weekly productivity and accuracy

goal for analyzing and interpreting a wide variety of plan benefits,

provisions and exclusions.

13. Recognized for achieving above standard accuracy level in claims

processing.

14. Helped achieved departmental goal by efficiently and accurately

reviewing, evaluating and authorizing payment of dental claims within the

benefit descriptions and plan provisions of a variety of group plans.

15. Processed over 150+ dental claims daily by applying standard claims

guidelines, such as coordination of benefits, verification of student

status on over-age dependents.

16. Successfully trained peers in adjudicating and resolving problem

claims.

River City Medical Group, Sacramento, CA

Provider Relations Representative

2005-2009

17. Increased organizational productivity, efficiency and accuracy to 90%

by collaborating with IT department in facilitating the implementation

of electronic claims and authorization submission.

18. .Developed recommendations and suggestions to Supervisor in an effort

to continually improve customer service operations

19. Handled client relationship management functions, which included

promoting enduring relationships with a diverse clientele.

RESUME OF CHARMAINE AQUINO

Phone: 510-***-**** Email: acgczk@r.postjobfree.com

20. Increased client base by successfully conducted office visits,

community events and In-service meetings with HMO partners in providing

health education and awareness to provider community.

21. Achieved a high-rate turn around time for contracting, credentialing

and system update requirements due from over 400 + providers

22. Managed and trained over 300 + providers in resolving administrative,

claims, billing and operational issues.

UFCW-Roseville, CA

Medical Claims Adjuster

2004-2005

23. Received recognition for achieving 100% accuracy rate in claims

processing.

24. Initiated automation of claims which resulted to increased production

to 80% and 0% error rate.

25. Reduced Inter-departmental error rate to 1% by training peers in

adjudicating a wide and diverse array of medical insurance claims.

EDUCATION

US Career Institute - Currently taking Medical Billing and Coding

Specialist course on-line.

Coursework completed - BS in Foreign Service, Lyceum University of the

Philippines.

Completed on-line courses, EDS University.

TECHNICAL TRAINING

Tools: Visio, MS Excel, MS Access, EPM, TSO

Databases: SQL Server, CA-MMIS, EZ-CAP. EZNET, NextGen

Reporting Tools: Crsytal Reports, ADHOC

Methodologies: SDLC

Languages: VBA

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