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Medical Administrative Assistant

San Francisco, California, United States
January 13, 2018

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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

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