Administrative/clerical/data entryfor Insurance Co/Med Clinic/Hospial
Resume:
DOLORES PALUMBO
*** ***** *** ****** ********** CA 90640 323-***-**** **********@*****.***
OBJECTIVE
To obtain a position as a claims assistant in an insurance company which would utilize my growing claims knowledge and provides opportunities to expand my skills in the Workers’ Compensation industry and/or Health Care Industry..
SKILLS PROFILE
-Fluent in Spanish both Spoken and Written
-Proficient in Microsoft Office Suite
EMPLOYMENT HISTORY
Benefits Advisor, Aflac 09/05/2017-03/30/2018
Pasadena, CA
-An independent agent representing Aflac
Claims Assistant, Amtrust North America
10/1/2015 9/5/2017
Covina, CA
-Issue benefit notices /forms and set reminders for decision dates (PD delay decision due, claim delay notice decision due, etc.).
-Issue benefit payments and set-up pay diaries for any subsequent payments due.
-2 point contacts (medical provider/employer).
-Contact medical providers and/or employers for medical/employment status.
-Issue bill objections to providers.
-Issue payment for in-house bills.
-Set up medical appointments, send appointment notice and advanced mileage.
-Create and submit EAMS documents to WCAB.
-Complete and submit litigation referral.
-Copy work (IMR, Subpoena of Records, etc.)
-Medical treatment denials.
-Check issues (overnight mailing, stop pay request, bounced/returned check research).
-Vendor issues (W9 request and follow up, address change, add new vendor).
Claims Assistant, Springfield Insurance Company
2005-2015
Covina, CA
-Provides clerical support to multiple claims adjusters and performs related work as required.
-Set up indemnity/litigated and medical only claims.
-Initiate 3 point contact.
-Process all benefit notices in a timely manner.
-Issue disability payments timely ensuring no penalties due to late payments.
-Review and process payments from invoices received from vendors, doctors, applicant and defense attorney’s.
-Research bill calls and answer all questions and/or resolve issue by processing payment.
-Ensure proper closure of files when applicable.
-Interface with doctor and attorney offices, employers and claimants.
-Provide back-up assistance to mail room clerk: open, sort, date stamp and index all incoming mail. Process out -going mail.
Accounting Clerk, Unified Grocers Insurance Services
2004-2005
Covina, CA
-Posting of cash receipts (identify checks, post payments, small balance w/o and moving credits to open balances).
-Checks Log.
-UGIS deposit.
-Printing/mailing of dunning letters and statements.
-Printing/mailing broker statements.
-Reprinting of invoices and statements
-Filing accounts for collections with Charter Adjustment Corporations.
-Cancellation of policies for non-payment.
-Reinstatement of policies upon receipt of payment if prior to cancellation effective date. If no payment, forward to underwriting department.
Accounting Clerk, Russell and Miller
2004-2004
Santa Fe Springs, CA
-Collections (A/R, high volume calls to customers).
-Daily invoice printing and mailing.
-Correspondence (customers, collection agencies).
-Order release of shipment to customers (daily, expedite, cumulative).
-D&B placement (filing collection claims with letter writing service).
-Reconciling customer accounts.
Medical Biller/Collector, Beverly Hills Orthopedic Group
2001-2003
Beverly Hills, CA
-Billing and collections for 3 orthopedic surgeons.
-Review and mailing of patient statements.
-Insurance and patient correspondence.
-Electronic submission of claims.
Medical Collector/ City of Hope
2000-2001
W. Los Angeles, CA
-Medicare collections.
-Review and mailing of patient statements.
Claims Processing and Auditing, Medical Pathways
2000-2000
Cerritos, CA
-Process encounter / senior claims.
-Locating, comparing and coding problem / error claims utilizing three software programs.
Business Office Manager, Elmcrest Convalescent Hospital
1998-1999
El Monte, CA
-Medical biller / collector (Medicare, Medi-Cal, HMO & Private Ins.).
-Maintenance of daily / monthly census reports.
-Prep. & submittal of long term care Medi-Cal applications.
-Posting of all cash receipts (A/R).
-Management of patient trust funds.
-Management of patient trust / facility petty cash and bank accounts
Operations Manager, Bilingual Psychological Associates
1991-1998
Montebello, CA
-Front and back office management.
-Medical biller/collector (HMO, Medi-cal, Medicare & Private Insurance).
-Accounts receivable/accounts payable.
-Management of HMO contracts and authorizations.
Education
California State University, Long Beach CA
BS, Business Management - 1998
References
Available Upon Request
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