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Customer Service Medical

Carson, California, United States
24.00 hr
December 21, 2018

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Sosefina T. Amisone


*** **** *** ******

Carson, CA 90745


To pursue a career in an established organization that will enable me to

demonstrate my analytical skills as well as my extensive Government and

Commercial Billing & Collection knowledge.


08/2010- 10/2018 Medassets/Nthrive El Segundo, CA

Commercial Patient Account Rep

* Follow up on all Commercial, hospital and physician claims

with Medicare advantage HMO, and Medi-Cal Crossover claims from billing through final resolution.

Review and prepare a minimum of 40 corrected claims for paper and

electronic billing resubmission.

Follow up on payment status, review and research denials to expedite payment.

Research accounts for payment errors, underpayments, denials, and

credit balances.

Adjust and Adjudicate account upon review of Medicare RA’s and

Commercial EOB’s.

Research credit balances, apply adjustments, and transfer balances to patient or secondary insurance for billing, posting payments.

Obtain proper authorizations, and correctly updated to patients accounts.

Work high dollar claims; up to $1 million.

Handled appeals, refunds, payment posting EOB analysis, correspondence, and customer service.

Review and worked aged reports for over and under paid claims for timely follow up and resolutions.

Verify claims paid correctly through contract manager.

04/2004 - 08/2010 Pacific Health Corp Tustin, CA

Commercial Patient Account Rep

Follow up on all Commercial claims billing through final resolutions

Re-bill and reprocessed claims, submitted appeals on denials, processed adjustment and write-offs

Reviewed EOBs identified missing charges, incorrect coding send it back for coding review.

High Dollar collection

Follow up with Workers Compensation claims.

02/2001 - 04/2004 American Medical Response Carson, CA

Eligibility & Collector Patient Rep

Verify patient eligibility and benefits for all payers

Take payment from patient over the phone

Set-up payment arrangement with patient.


2001-2002 Brymen College Medical Office Management Gardena, CA

1986-1990 Carson Senior High Diploma Carson, CA

Sosefina T. Amisone


Bilingual - English primary, Samoan –Fluent secondary


Accurately interpret Medicare RA’s and EO B’s, Insurance Verification, HIPPA guidelines awareness, Knowledge of various hospital system such as Collections Management, Epic, Cerner, Medi-Cal system verification, Medical terminology, CPT, ICD9 & ICD 10 codes, knowledge of all Microsoft windows, UB-04 and CMS claim forms as well as other office programs.

Awards Received

Incentives for meeting quota every qtr.

Incentives for meeting collections every qtr.

Incentives for meeting productivity every qtr.

Computer Skills

Microsoft word

Microsoft excel

Microsoft office

Power Point

Type 55 wpm

10-key 10,000 KPH

Licenses and Certificates

Graduated with Honors from Brymen College

Perfect attendance certificate

High School Diploma

Reference upon request

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