NILSA SANTA

**** ********** ****.

Stone Mountain Ga. 30083

267-***-****

ac6o2k@r.postjobfree.com

SUMMARY

Years of experience and knowledge in the medical field, as a medical office assistant, collections, billing, registration, precertification & customer service. My strongest points are being reliable, dependable, hard working and a self-starter.

(looking for night and or weekend hours only)

WORK EXPERIENCE

Georgia Cancer Specialist 10/2015-Present

Precert/Referral Specialist

Monitoring precertification orders from 9 offices

Applying online requests for pre authorizations

Follow up on pending statuses online or by phone call

Keeping the doctor offices notified of denied orders or if additional clinical information is needed.

Staffing Resources (Temp. service) 07/2015-09/2015

Patient Care Coordinator

Northside Dekalb Imaging

Responsible for 19 different center locations; requesting clinical notes and the order from the doctor offices, once I receive them I then scan them into the patients account. A confirmation email is sent when this is done

Called doctor offices when a Peer to Peer review needs to be completed.

Logged onto a spreadsheet all clinical notes/orders I have requested, Peer to Peer phone calls and properly noting the patients account

Staffing Resources (Temp. service) 4/2015-07/2015

Medical Scheduler

Northside Snellville Imaging

Medquest(formerly known as) Snellville Imaging

Answered 3 phone lines from patients, attorney offices, doctor offices and lien companies

Retrieved via email doctor’s orders and submitted to funding companies for approval

Scheduled appointments for patients that were approved for funding and kept a proper og

Kept doctor offices, attorneys & funding companies update on patient appointment details

Scanned in orders of appointment time and procedures to appropriate office (22) locations

Lower Bucks Hospital 04/2014-02/2015

Patient Access Registrar (Outpatient and Emergency room)

register patients for outpatient services (radiology, emergency room and laboratory)

verify and copy all insurances and identification

data entry

pull referrals and authorizations for the necessary insurances

(ER) intake the patient is a timely manner

admit and assign rooms to patients that are being admitted to the hospital

retrieve information from patients that are already in the back via rescue squad

Always Best Care Senior Services 01/2014-04/2014

Home Health Aide

• Aided with morning wake up, afternoon and evening assistance (lunch, snack, dinner)

• Provided medication reminders, assist with walking

• Changed linens and make beds

• Planned and prepared meals, assist with pet care

• Groomed, dressed, bathed, incontinence/toileting and mobility

TRC Staffing, Langhorne PA 10/2013-11/2013

Customer Service (6 week temp. position)

Made inbound and outbound calls to customers verifying or completing their registration for rite aid wellness 65 plus card holders.

data entry, verification

ARMDS, Burlington, NJ 09/2010-02//2012

Collections/Billing

Made phone calls to secondary insurances, checking the status of unpaid claim.

Navinet, RAS, Emdeon, Health Quest and Managed Med online systems to retrieved claims, eligibility and patient information.

Re-billed claims for appeal or as a corrected claim to be paid on properly.

Thoroughly noted the account as to where the claim currently stands.

Submitted payment information to Supervisor if they are not posted in the patient's account.

WJO Inc., Bristol, PA 11/2007-07/2010

Collections

Made calls to Attorney offices and Insurance companies to check status of cases or payment on workman’s comp., slip and fall, motor vehicle, other accidents, DME and therapeutic

magnetic resonance

Resubmitted claims to health insurances as secondary insurance claims.

Checked Navinet for payment, denials and eligibility

Sent claims by fax or by mail with the information needed to get a claim paid.

Billing; entered charges and payments, apply deductible and co-pays to account.

Reviewed account to make sure all dates of services were paid on-time.

Planned Parenthood, Bristol, PA 09/2004-10/2007

Medical Office Assistant

Verified insurances, entered charges from the super bill and scheduled patient appointments.

Disbursed birth control, pulled chart and attached lab results, gave them to Nurses for review.

Closed cash drawer two nights a week and securely closed the building.

Responsible for bank drop off every Friday.

Planned Parenthood, Bristol, PA 06/2003-09/2004

Healthcare Assistant

Performed blood pressure, weight and BMI information.

Collected urine sample for pregnancy test, urine analysis and STD testing.

Assessed the patient for their visit, performed hemoglobin sticks and logged lab results

Properly prepared requisition sheets according to patients insurance and testing to be done.

Medical Field, Various Medical Temporary Positions (below) 02/2000-06/2003

Omni Medical Management, Bensalem, PA

Office Assistant

Experience in billing & collection for ear, nose and throat.

Called insurance companies to check for status of payments, made sure doctors were credentialed with insurances and entered charges.

Dr. Zankman, Middletown, PA

Front Desk Receptionist for a Pediatric Office

Scheduled and verified appointments.

Documented charts, entered charges into billing system.

Lower Bucks Hospital, Bristol PA

Office Assistant

Scheduled appointments, entered anesthesia charges into system and dictated notes for doctor

Pre-certified and obtained referrals for pain management procedures.

Typed and mailed out follow up referral letters to referring doctors.

EDUCATION

National Healthcare Association 08/30/2013

Certified EKG Technician

Bucks County Community College, Newtown, PA

EKG Technician 07/2013-8/2013

Morrisville-Yardley Family Practice, Morrisville, PA

Phlebotomy Externship 07/2011-08/2011

Planned Parenthood of Bucks County, Bristol, PA 05/2011-07/2011

Phlebotomy Externship

Bucks County Community College, Bristol, PA

Phlebotomy Certificate 01/2010-12/2011

(willing to perform on the job training at a temporary pay decrease)

National Center for Competency Online Test

Certification: Medical Insurance and Billing 06/2009-07/2010

Pennco Tech, Bristol, PA

Diploma: Medical Billing/Administration 02/2000-06/2000

Contact this candidate