Insurance Medical
Resume:
Gemma L. Trahan
Suffolk, VA *****
abkhxb@r.postjobfree.com
OBJECTIVE
To obtain a position in a Healthcare Industry in which my experience and skills can be effectively
utilized for mutual benefits.
SUMMARY
A dedicated and team player who works well under pressure and enjoys challenges. Exhibits
particular strengths in:
Ability to learn systems Handling multiple tasks simultaneously
Word processing Computer functions
Organization Diligent worker
ACCOMPLISHMENT
Temporary in Direct Mail Campaign and promoted to and achieved
permanent candidate in June-October 2001 with various skills and knowledge.
Top performer two times in a row, perfect attendance, MVP award while in Direct Mail Campaign.
Reduced the turnover time for processing credit applications from 4 days to 2 days, which
increased processing time by 50%. Top Performer 3 times in 3 rd quarter 4th quarter 2003 in
Government Card Service. Top Performer 1st quarter 2004 in Government Card Service. Perfect
attendance for 2003, 1st quarter 2004 in Government Card Service. No error for the 3 rd quarter in
2005 audits in Medical Billing
Collected $100,000 from insurances and past due patients within Mid Atlantic Division
WORK EXPERIENCE
Tidewater Physician’s for Women (MAWC) Virginia Beach, Virginia (Aug 31, 2010-Present)
Medical Biller, Billing Department
Responsible for following up claims status and submission of claims to insurance companies.
Update patients demographics in Digi chart and Athena (database). Responsible for tracking
payments/credit/refund from insurance, patients and within the MAWC. Verify billing information,
patients demographics data for billing purposes. Call patients in reference to past due accounts
and payments arrangement. Responsible for collecting bad debt from patients and sending
collection letters to Collection Agency. Entered Obstetrical, circumcision, and discharge charges
using CPT and ICD-9 codes in the timely manner before the end of the month report . Verify
benefits coverage on the patients policy. Review medical notes in Digi Chart and operative notes
in Epic when claims in denial by insurance. Request missing eob’s from the insurance company
and within MAWC practice to submit to Athena to post when necessary. Speaks Tagalog (Filipino
language) to the patients when necessary. Assisted front desk when short in staff.
Medical Management Services Chesapeake, Virginia (Dec 2008-March 19, 2010)
Medical Biller, Billing Department
Responsible for following up claims status and submission of claims to insurance companies.
Updated patients demographics in Prism (database). Responsible for tracking
payments/credit/refund from insurance and patients. Verified insurance information, patients
demographics data for billing purposes. Responsible for collecting bad debt from patients.
Called patients in reference to pass due accounts and payment arrangement when necessary.
Verified benefits coverage. Speaks Tagalog (Filipino Language) to the patients when necessary.
Resubmit claims along with medical records/Operative notes when claims in denial by payor(s).
Assisted keying requisitions/superbills when necessary. Assisted coding ICD-9 when co-worker
needs assistance. Requests notes and legible requisitions/superbills from physician’s office.
When assigned projects, completed in the timely manner. Responsible for completing AR
monthly report within the monthly time frame. Responsible for checking claim status online and
via phone on various insurance companies.
Tidewater Physician’s for Women (MAWC) Virginia Beach, Virginia (March 2007-December 2008)
Medical Biller, Billing Department
Responsible for following up claims status and submission of claims to insurance companies.
Update patients demographics in Digi chart and Athena (database). Responsible for tracking
payments/credit/refund from insurance, patients and within the MAWC. Verify billing information,
patients demographics data for billing purposes. Called patients in reference to past due accounts
and payments arrangement. Responsible for collecting bad debt from patients and sending
collection letters to Collection Agency. Entered Obstetrical, circumcision, and discharge charges
using CPT and ICD-9 codes in the timely manner before the end of the month report . Verified
benefits coverage to the patients policy. Review medical notes in Digi Chart and operative notes
in Ecare when claims in denial by insurance. Request missing eob’s from the insurance and
another practice within MAWC and submit to Athena (system) to post. Speaks Tagalog (Filipino
language) to the patients when requests. Assisted front desk when short in staff.
The New Hope Center for Reproductive Medicine (MAWC) Virginia Beach, VA (May 22, 2006-
March 2007)
Medical Biller, Billing Department
Responsible for inquiring claim status with insurance companies. Updated patients profile in
database and digicharts. Responsible for tracking payments/credit/refund from insurance,
patients and offsite office. Verified billing information, customer demographics data for billing
purposes. Take incoming calls from patients in reference to medical bill, payments posted and
appointments. Schedule patients appointments for follow ups. Search patients chart for detailed
medical record dos (date of service) to submit claims to insurance. Assisted co-worker when
needed help with patients statement cycle to mail out. Assisted co-worker in the front desk to
verify appointments and insurance, and scheduled appointments and forward messages to
doctors and nurses.
LAB CORP, Chesapeake, Virginia (Feb 28, 2005-May 19, 2006)
Medical Biller, Billing Department
Responsible for performing specialized processing of accounts receivable issues requiring
advanced training and technical skills. Responsibility includes credit/refund correspondence and
research, audit and review support, RCDM analysis, and letters of credits and communications.
Verified billing information, customer demographics data and laboratory data identification and
results, for computer processing. Resolves suspend and billing problems and manually process
OE batches. Follows standard sequences and coding in entering and keying in data in correcting,
editing, and verifying all data entered into automated systems. Handles incoming/paging
overhead billing inquiries. Assists co-workers in processing letters of suspends.
BANK OF AMERICA, Norfolk, Virginia (June 2001-October 2004)
Operator Representative, Government Card Service
Responsible for processing statements, post cards, credit cards, correspondence, and transfer
transactions. Replying back to via email Kana. Monthly report submitted to managers. Assisted
co-workers in processing credit balance refund. Answered and screened over 300 telephone calls
per month. Trained associates on processing transfer transactions to maintain the three days
turnaround.
BANK OF AMERICA, Norfolk, Virginia (May 2000 - June 2001)
Support Specialist, Commercial Card Department (October 2000 - Present)
Responsible for processing business credit applications, verify approved applications, and setting
up account. Assisted co-workers in verifying, filing, and processing applications when needed.
Answered and screened over 700 telephone calls per month
Organized and expedited over 425 approved applications credit cards
ADECCO, Virginia Beach, Virginia (June 2000 - October 2000)
Data Entry/Credit Analyst, BOA, Direct Mail Campaign, Commercial Card
Processed 170 business credit card applications per day with 100% accuracy under pressure of
heavy workloads and deadlines. Responsible for checking customers banking relationship,
calculated cash flow, and making the qualifying decisions based upon credit bureau report.
Trained new associates as Data Entry and Credit Analyst
Analyzed and identified fraud applications in various queues.
Requires Inquire Alpha Lookup (IAL) in TS1 and Ace Advantage systems
ALL ABOUT TEMPS, Norfolk, Virginia (May 2000 - June 2000)
Data Entry, Bank of America, Government Card Department
Processed over 50 government cards in hot and expedite applications for federal express per
day. Inquired lookup customers account information into the TS2 system to check for duplicate.
Entered amount of applications per day in log sheets. Filed existing accounts by date.
SPECIAL SKILLS AND TRAINING
CPC Certification
Speak and write fluent in Tagalog
Oral and Written Communication
Type 60-70 wpm
EDUCATION
American Academy of Professional Coders 2009
Virginia School of Technology, Practical Nurse 2004
Tidewater Technology, Computer Administrative Assistant 1999
Green Run High, General Graduated June 1996
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