Medical Administrative Assistant
Resume:
Phillip S. Hamilton
San Francisco CA *****
415-***-**** • *****************@*****.***
SUMMARY OF QUALIFICATIONS
● 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
EDUCATION
Associate of Arts Degree, Applied Sciences, Business Administration Heald Business College, San Francisco, CA
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