Sosefina T. Amisone
ac702k@r.postjobfree.com
Carson, CA 90745
Objective:
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.
Experience:
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.
Education
2001-2002 Brymen College Medical Office Management Gardena, CA
1986-1990 Carson Senior High Diploma Carson, CA
Sosefina T. Amisone
Languages
Bilingual - English primary, Samoan –Fluent secondary
Skills:
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