Office Assistant Customer Service
Resume:
NILSA SANTA
Stone Mountain Ga. 30083
**************@*****.***
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
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