Medical Billing Data entry claims examiner

Nyretti Fuimaono

**** *. ******** ****, ***. #***, Las Vegas, NV 89121 702-***-**** *******.*@*****.***

Professional Summary

Responsive Medical Claims Processor with a strong attention to detail and the ability to juggle multiple tasks while checking the inbox daily to ensure that claims are handled in a timely manner. Seeking a new position where a strong work ethic and exemplary time management skills will be appreciated.

Education

MEDICAL BILLING 2004 REGIONAL OCCUPATION PROGRAM

·Medical Billing

GED 1983 LONG BEACH ADULT SCHOOL

·General Education

Experience

MEDICAL CLAIMS EXAMINER HEALTHCARE PARTNERS AUG 2016- MAY 2017

Las Vegas, NV

·Analyzed and updated all required document for appropriate Medicaid Claims into system.

·Assisted mail room with EOB Letters.

CLAIMS EXAMINER ALL TEMPORARY AGENCY- ATI JUL 2015-AUG 2015

Fountain Valley, CA

·Examine report accounts and evidence to determine integrity and accuracy of information.

·Entered Data promptly and efficiently with accuracy.

·Evaluated the quality of data entered in the Management Systems.

ASSOCIATE ANALYST MOLINA HEALTHCARE, INC. JUL 2013-DEC 2014

Long Beach, CA

·Examine report accounts and evidence to determine integrity and accuracy of information.

·Analyze information received from outside party(s) for updates in computer system(s).

·Load and maintain provider information in software/data base.

·Assist in system health plan integration related testing.

·Audit loaded provider records for quality and financial accuracy.

LEAD CLAIMS SUPPORT MOLINA HEALTHCARE, INC. SEPT 2012-JUL 2013

Long Beach, CA

·Analyzed Departmental documents for appropriate distribution.

·Directed and coordinated the production processing

·Prepared and maintained production reports and managed team performances by training staff.

·Ensured compliance with policies and practices

·Assisted in supervisor/management in department performance standards weekly meetings.

PREPROCESSOR MOLINA HEALTHCARE, INC. FEB 2008-OCT 2012

Long Beach, CA

·Managed a large volume of Medical Claims daily while ensuring efficient processing.

·Review paid or denied Medical claims based upon established claim processing criteria.

·Utilized administrated guidelines as a resources or to answer questions when processing principles, medical terminology, procedures and HIPPA regulations.

Professional References

Available upon request

Contact this candidate