Customer Service Administrative Assistant

JANIE LOPEZ

Objective

I am interested in working in a position that utilizes my skills, experience, education and potential. I am a multi task and detail oriented team builder with extensive computer skills as well as organizational leadership skills.

PROFESSIONAL EXPERIENCE

8/22/2016 – 11/18/2016 Temp position Verity San Jose Medical Biller

Follow up and rebilled outstanding balance of patients & insurance companies, review & research accounts on aging.

Called insurance company’s regarding patient eligibility.

05/05/2016 – 07/29/016 Temp position UAS San Jose

Customer service calls, also gave insurance coverage to Dr’s offices & Hospitals.

process medical & dental claims.

01/27/2015 – 05/04/2016 Dr Emami San Jose Ca Medical Biller

Office & Hospital Billing visits for two Neurologist, sent out statements, follow up on outstanding balance of patients & insurance companies, review & research accounts on aging, follow up calls to patients & insurance companies, post payments.

09/08/2012 – 12/7/2013

Planned Parenthood Mar Monte San Jose, CA

Cash Clerk II

Handle health center’s DPLs (daily patient logs), petty cash requests, and patient refunds,

Process Education Group Funds and stipend requests,

Processing checks daily, ensure all deposit receipts are accounted for all departments’ data entry of other revenue daily cash receipt transactions into Solomon system.

Analyze and reconcile DPL reports with the deposit tickets to ensure NG and Solomon systems match.

Report in writing any discrepancies to management, including supporting documentation and resolution.

04/1996 – 09/07/2012

Planned Parenthood Mar Monte San Jose, CA

Medical Biller

Performs regular audits and posting of surgery coding, reimbursement and fee schedule analysis for reimbursement maximization.

Responsible for timely updates to the practice management system as well as other internal billing systems. Supports.

Train staff in billing and reimbursement.

Monitors and updates clinic service codes and charge entry documents to ensure consistency with government and contractual (HMO/PPO) standards, guidelines, restrictions, obligations and reporting requirements.

Evaluate payments in accordance with contract allowances. Review and research account problems and finds resolution. Resolve patient and insurance company correspondence.

Overflow/back-up of posting charges, adjustments and/or payments. Prepared banking for deposit.

11/00-10/02

Planned Parenthood mars Monte San Jose, CA

Administrative assistant

Evaluates provider and member grievance and correspondence, and responds accordingly. Presents grievance cases to the committee board members weekly and responds appropriately.

Submits and verifies required data and analyzing of reports. Prepares written status reports within time frames and assist with department projects. Maintained strong commitment to professionalism while concurrently functioning as a patient advocate.

Printed the minuets and updates for monthly meeting for the CFO.

Summary of qualifications

Proven ability to communicate effectively both orally and in writing.

Highly organized with attention to detail and talent for assessing client needs and gaining trust.

Knowledgeable in California State guidelines for managed care and private health plans.

Detailed knowledge of professional, outpatient facility and diagnostic coding systems including: CPT, HCPCS, ICD-9, HCFA 1500 and others. Working knowledge of Medicare, Medi-Cal, HMO and PPO contracts as they relate to coding, charges, reimbursement and data management. Working knowledge of physician compensation and revenue reporting.

This includes advanced understanding in PPO, HMO, and POS benefits, referrals / authorizations and provider contracting, Advanced knowledge in Microsoft Word, Outlook, Excel, Access, and PowerPoint.

1466 MOUNT WHITNEY DR• SAN JOSE, CA 95126

PHONE 408-***-**** • E-MAIL ********@*******.***

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