Sign in

Medical Administrative Assistant

San Francisco, California, United States
January 13, 2018

Contact this candidate

Phillip S. Hamilton

San Francisco CA *****

415)***-**** •


● Qualified and certified medical billing and administration specialist with current experience at UCSF, handling all Medi-Care and Medi-Cal accounts.

● Superior knowledge with billing systems to include APeX/EPIC.

● Proficient with the Microsoft Office Suite and Data Entry

● Recognized for commitment to working with diverse populations

● Ability to effectively communicate in friendly and positive manner with internal and external constituents RELEVENT SKILLS AND EXPERIENCE

J osephine's Personnel Service San Francisco, CA 6/2016-9/2016 B illing Analyst

● Assist/advise customer on product functionality in order to streamline business processes and provide customers’ business with a competitive advantage.

● Follow standard operating procedures to ensure billing accuracy.

● Complete daily, weekly and monthly processing for customers including billing and generating invoices.

● Respond to and complete customer phone calls, e-mails, and service requests completely and in a timely fashion.

● Use time tracking application to track hours spent working for individual customers.

● Maintain product knowledge by learning and becoming proficient on new software releases.

● Participate in on-call pager/cell phone support as needed.

● Uphold company policies and procedures

● Perform additional related responsibilities as requested.

● UCSF Medical Center/Radiology Billing Dept. San Francisco, CA 7/2015-10/2015 Administrative Assistant Revenue Management

● Manages the billing work queues {WQ} in APeX on a daily basis, keeping edits at a minimum by working deficiencies in WQ (The WQ areas include but are not limited to Router WQ, Charge Review WQ, RFI WQs and authorization WQs)

● Works and communicates effectively with coworkers and external coders to resolve any billing/charge capture related issues

● Able to identify and provide feedback on outstanding issues

● Addresses patient billing questions and triage calls as needed

● Provides requested documentation such as operative reports, doctor’s notes, and insurance info to aid in the reimbursement process

● Obtains required authorizations of procedures while maintaining current list on those insurances (this includes pre-service, post service retro/modifications and appeals if needed)

● Contacts insurance companies directly on accounts that may need additional follow up for claim resolution

● Demonstrates competency in the APEX system.

● Maintains confidentiality of all patient information

● Performs other duties/projects as assigne

● Ensure all billing documentation required by payers, including but not limited to CPT-4, HCPCS and ICD-9 coding, ICD-10 prior authorization, provider identifications, primary and secondary insurance, patient demographics, insured identification, charges and dates of service are complete and correct. Institute on Aging San Francisco, CA 7/2014 – 4/2015 Medical Records and Medi-Cal Billing Specialist

● Ensure accurate and timely MediCal, MSSP, CLF, CCT San Mateo billings on a monthly basis.

● Request medical information from physicians for newly enrolled clients and re-assessments

● Provide successful follow-up efforts for MSSP, CLF, CCT San Mateo Billing, including appeals process for denied claims.

● Follow-up on any claim denials to complete resolution.

● Review and resolve claim submission errors.

● Make recommendations for improving MSSP, CLF standards and procedures to improve billing and collection processes

● Tracks and provides follow up of outstanding receivables;

● Submitted 1500 Claim forms and EB4 to Medi-Cal for Reinbursement

● Audit and review MSSP,CLF, LINKAGES, charts for yearend review.

● All other reasonably related projects as assigned. Medical Group Business Services (Aroteck) San Francisco, CA 9 /2013 – 11/2013 Documentation Archivist (Temporary)

● Maintained the integrity and consistency of the internal filling of MGBS documents

● Researched and retrieved batches as requested by MGBS staff, MGBS management, or client departments within the timely standard defined unit

● Located and copied specific documents within a batch when needed

● Picked up, opened and sorted incoming mail, and distributed to appropriate units and/or UCSF departments

● Entered daily electronic data as it pertains to scanned documents

● Maintained office supplies and storage area for office supplies and materials

● Ordered and distributed office supplies as required

● Performed other duties as assigned

Medical Group Business Services (UCSF) San Francisco, CA 6 /2011 – 09/2012 Billing Assistant (Temporary)

● Utilized APeX, IDX BAR, IDX PCS,IDX VM, Acculog, IMF, Cirius Prebill, SMS, DDE,STOR,IDX, DecRad, EMRWeb and other billing systems

● Patient registration- online registration verification, accessing commercial and government payer websites and verifying eligibility and claim status

● Sorted hardcopy bills stratified by payer and representative assignment, and reviewed bills for general accuracy and completeness

● Submitted bills with required documentation to payers in a timely manner in accordance with department and payer requirement

● Secured all forms and pertinent information required for billing, to include medical records, explanation of benefits and remittance advice

● Coordination of benefits information, departmental reports, authorizations/pre-certifications and Treatment Authorization Request

● Submitted requests to department via e-mail or documentation request process and reviewed response for appropriate action

● Entered online notes to provide an audit trail for future follow-up and initiated charge correction requests

● Effectively communicated with MGBS staff

● Notified manager of possible procedural change for improving efficiency-incorrect billing address, subscriber number, and medical group assignment

● Provided support for Front Desk when needed, by answering phones, processing reimbursements and maintaining facilities


Associate of Arts Degree, Applied Sciences, Business Administration Heald Business College, San Francisco, CA

Contact this candidate