Medical Data Entry

Lorraine Martinez

Phoenix, AZ. ***** 623-***-****

**************@*****.***

JOB OBJECTIVE

I am seeking a permanent position that could enhance my career and provide personal and professional fulfillment. In addition to obtaining a challenging and responsible position that offers opportunity for growth, I truly enjoy working in the Healthcare field.

SUMMARY OF QUALIFICATIONS

KSA’s include the ability to quickly learn new tasks and to work independently with minimal supervision. 15 years of experience as a qualified medical biller from the Health Insurance Industry. Efficient, high producer and excellent customer relation skills Promote responsible behavior, confident, and produce quality work

PROFESSIONAL EXPERIENCE

Collections Medical Terminology CMS, 1500’s and UB’s

Re-submissions Monthly Posting Insurance Verification

EMPLOYMENT HISTORY

Cognizant Technology Solutions – Senior Claim Examiner 10/13- 02/16

Medicare/Medicaid/Commercial lines of business

Verify and analyze data utilized in processing medical claims. Ensured that claims were keyed with accuracy and processed accordingly to the health plans guidelines audited all lines of business including Medicare, Medicaid and commercial plans. This includes member and provider claims along with any applicable coordination of benefits Also, to ensure the work is completed in a timely manner to ensure any time around requirements are met. This role utilized FACETS and QNXT.

GeriPro, Inc., Medical Billing 06/06 - 08/08

Process Billing, Collections, Posting, and verify insurance coverage. Customer Service duties include communications with facilities, and insurance companies. Review appeals appropriately and process. Check Claim Status on-line and by phone. Reading remits advice payments and denials. Determine the next course of action for re-submissions or appeals. Reconciled EOB/EOBM reports with the supervisor (Medicare/Medicaid, AHCCCS, B/C & B/S and various other insurances)

Schaller Anderson Health Care, Claims Analyst III 11/02–03/06

Accurately adjudicate claims in accordance with health plan guidelines, company standards, and company procedures for one or more lines of business (this includes inventory claims, COB claims, pends, quality review claims, unfinished claims report and adjustments). Assist other team members and research as needed. Pull and assign reports for the team, and participate in inter-department projects when required.

State of Arizona DES, Comprehensive Medical & Dental Program (CMDP), Claims Specialist II 06/02–10/09

Processing medical, dental, HFCA, and Hospital (UB92) claims to achieve standards of quality and production. Review CPT codes and enter claim information and/or corrections. Knowledge of AHCCCS Rules and Regulations and Medical Terminology were a critical component of the aspects of the job. Prepare statistical and narrative claim reports. Meet deadlines efficiently and timely.

Indian Hospital (IHS), Medical Records Clerk 03/01-03/02

Performed a variety of clerical duties, which included sorting, filing, and medical record management. Assembly of ambulatory clinic visits, and record retrieval Answering phones and assisting other personnel in hospital departments.

SoNora Quest Laboratory Specimen Processor/Coding 1999-2001

Data entry of patient demographics, receive accession and label specimens. Specimen processing including separations, storages, and send out testing protocols. Organize and prioritize a variable amount of workload. Handle sample, specimen procurement and data entry of general office duties.

EDUCATION

Medical Billing and Processing Computer Institute, Salt Lake City, Utah

Medical Records Management Navajo Community College, Tsaile, AZ

Administrative and Clerical Utah Technical College, Salt Lake City, Utah

Contact this candidate