Project Manager Customer Service
Resume:
PAULINE BILICIC
Las Vegas, Nevada 89110
OBJECTIVE: To obtain long term employment with challenge and growth
opportunities.
EDUCATION:
**** - **** **.* **llege Units from Mira Mar College San Diego, Ca.
1993 - 1994 Nevada Career Institute, LV, NV. Medical Assistant Course
1979 Obtain General Equivalent Degree from San Diego, CA
2009 Obtain 2nd High School Equivalency at UMC request due to
unable to verify
VOCATIONAL: Completed and acquired certificates in office management,
collections, cashier,
Medical assistant, secretarial and benefit service
representative.
EXPERIENCE:
07/17 - 01/14 Bilicic Family
Care Giver to Home Hospice Patient
Assist in the daily care of my brother. Prep meals, fed
him, change bedding, administer medication, daily
hygiene, and gave full care as needed.
06/12 - 07/13 University Medical Center
Patient Acct Rep,
Worked to resolve accounts. take credit card payments.
Calls and customer service. Follow up with insurances and
Rebilled accounts.
Balance transfers and adjustments. Audit accounts and
submit appeals. Some
Power Point, Microsoft Word and Excel. Correct patient
information, verify insurance etc.
11/10 - 06/12 Dell Corp.
Traveled, Project Manager
Trained commercial billers and follow up. Contractual
adjustments.
Cash posting, accept and arrange payments, customer
service.
Trained staffing correct ways of billing, follow-up and
posting of payments.
Travel to variety projects in different states. Developed
appeal letters and
Patient letters. Worked excel spread sheets. Review
medical records for
Work comp related, auto accidents, medical necessity and
or for appeals.
Stayed Hippa Compliant and followed all Federal and State
Regulations.
Would give in service meetings for ways to resolve
accounts with insurances,
how to submit appeals and how to work an ATB. Performed
multiple tasks
in hospital business offices on and off site. Quality
assurance.. Experience on
Several different computer programs. Covered different
areas as needed, verify insurances and copay, worked
commercial, manage care, Medicaid work comp
And government insurances.
06/09 - 11/10 University Medical Center
Patient Account Representative
Worked and follow up on commercial and manage care
accounts and claims.
Submit appeals for non-valid denials. Resolve problem and
complaints with
accounts. Attend monthly conference calls with United
Health Care and
Insurances that uses the United Health Care network. Submit
contractual per contract and balance transfer. Work excels
spread sheets. Rebill, work JOC
reports, verify eligibility, Follow up phone calls to check
status, document action in the system, perform duties
within the guidelines of corporate compliance.
PAULINE BILICIC
Page 2
11/01 - 05/09 Perot Systems
Project Manager II - Travel to different Hospitals
Travel and work different hospital settings in business
office. Monitor, tracks
and follow-up on accounts to ensure payment of claims.
Submit appeals.
Review contracts, accounts, payments and explanation of
benefits. Review medical records. Run reports; assist the
director as needed, kept log of total daily accounts
worked. Attend meetings. Daily interaction with payors,
hospital staff, experience in HMO, PPO, Blue Cross, Manage
care, Commercial, Tricare, Medicaid and work man comps for
New Mexico, Texas, Nebraska, Nevada, Idaho, Alaska. and
Washington. Computer experience HBOC, Dairyland, Prodigy,
and Premis, SMS, Meditech, Cubs, Star, McKeson and
Affinity. Utilize all tools and systems to assure that
claims are submitted and procesed appropriately. Document
all actions taken on the account.
07/98 - 10/01 Sunrise Medical Center
Patient Account Representative, Payor Management
Public relations, review accounts and explanation of
benefits, computer, adjust
accounts, phones, audit accounts, A/R reconciliation,
insurance review, bad
debt accts., 40K report, interact with insurance and
patients, some Spanish
translation, pick up checks from insurance's, attend
meetings,
02/98 - 07/98 Horizon Specialty Hospital
Interdisciplinary Administrative Assistant (temporary
position)
Phones, fax pre-cert and referrals, write up admission
face sheet, pre-cert., type
insurance letters, team conference schedules and reports
in computer, insurance
verification, patient satisfaction surveys, referral
pending list, preparation and
maintenance, do cost outs, answer phones, public contact,
daily contact with
case Managers and social services, write progress notes,
Cover in medical
records when and as needed, etc.
REFERENCES
Ricardo Gallegos Carol Murphy Darlene Hammond Patricia
Cleveland
956-***-**** 702-***-**** 602-***-****
Harlingen, TX Las Vegas, NV Pheonix, AZ
Dallas, TX
PAULINE BILICIC
RE: Open Position
To Whom It May Concern:
I am interested in a position that I may qualify for, with your company. I
have over 15 years of customer service experience in both Business and
Medical. I believe I have a solid background and the experience to make me
highly qualified in those areas. I am looking for a permanent position
that offers challenge, variety, and the opportunity for growth. I do feel
that I could be an asset to your facility.
I am an honest, responsible and dependable person. I am capable of working
both independently and as an integrated team member. My skills include but
not limited to operational procedures of office management, customer
service, communications, data entry, word perfect, excel, insurance follow
up, secondary billing, cash posting payment transfer, intercommunication
skills, and so forth. I have also worked on multiple computer systems.
I would be very interested in joining your team and have enclosed my resume
for your consideration. I would also like to take this time to thank you
in advance for any consideration that you give in reference to my resume.
You may contact me at my cell number, 702-***-****. You may also leave a
message for a return call. Please leave your name and number along with
the name of the company you are calling from.
Sincerely,
Pauline Bilicic
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