Customer Service Medical
Resume:
Arnella C. Madriaga
South San Francisco, Ca
94080
Dr. Carmen Sabolboro - Office Assistant- Jan 2010- May 2012
South San Francisco, Ca 94080
Process all dental bills to be sent to the carrier
answer phone and schedule appointments for patients
Greet patients
Verify insurance coverage from carriers
Claims Assistant Examiner- Sedgwick CMS Jan 30, 2004- June 30, 2009
Oakland, Ca
Process new claims and make 3 point contact to Employer, Employee and Doctor
Set up medical appointment and provide customer service as required
Ensure all Indemnity benefits and Awards are paid on time
Process all approved provider bills timely
Prepare objection letters to providers for medical bills, delayed, denial
Contact treating physician for disability status
Handle medical only files
Send all DWC notices
Schedule appointments for AME/QME for evaluations
Send appointment letters, Issue TD/mileage and send medical file
Schedule Interpreters for appointments if needed
Request Job Descriptions from Employer
Request 5020, DWC-l and 5021
Subpoena Records
File and Serve documents on attorneys, WCAB, Doctors
Submit C&R, Stipulated Awards to WCAB for approval and documentation
Process checks- stop payment, cancellations, void
Conduct ISO reports to ensure if there are prior claim info from pass carriers
Various Temporary Assignment- Essential Staffing 2003
Assigned to various companies
Answer telephone calls, handled medical only claims and assist with claims Adjuster, Issue benefit payments
Send all DWC-l notices
Set QME/AME evaluation
Fremont Compensation - Medical Only Examiner 1992-2002
San Francsico, Ca
Initial 3 point contact
Review files to see if transferring to Indemnity
Send DWC letters
Process medical bills and review files for closure
Education
Star of the Sea Academy- San Francisco, Ca
Skyline College
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