Medical Billing/ Patient Account Rep./ Third Party Billing

SALLY NEMETH

*** **** ***** **. ***. *, MANTECA, CA. 95336 / C: 408 – 623 – 1691 / *************@*****.***

PROFESSIONAL SUMMARY

Ambitious administrative assistant with dedicated work ethic and excellent customer service skills. I have strong organizational and problem solving skills, and able to think outside the box. Likes to work independently or as cooperative team member. I am looking for a job that has potential for growth and is a challenging career.

LICENSES

Certified Professional Coder – American Academy of Professional Coders

SKILL HIGHLIGHTS

• ICD 9, CPT, HCPCS coding

• Knowledge of HMO’s, Medicare, Medi – Cal, and private insurance

• Knowledge of processing UB 04 and CMS 1500 forms and edits

• Strong medical terminology

• HIPAA compliance

• Knowledge of various medical software programs

• Microsoft Word, Excel, PowerPoint, and Office programs

• Fast learner of new computer programs

• Team player with positive attitude

PROFESSIONAL EXPERIENCE

Third Party Billing Specialist 04/2012 to 02/2012

Omnicare Pharmacy Lodi, CA.

• Closed door pharmacy that provides drugs to skilled and long term nursing facilities.

• Large scale company has many accounts with various skilled and long term nursing facilities.

• Point of sale adjudication for large volume of patient claims on daily basis.

• Resolved unpaid and rejected claims.

• Submitted treatment authorization requests for uncovered medications.

• Worked aging reports each month

Third Party Billing Specialist 12/2008 to 04/2012

Pharmacy Advantage Stockton, CA.

• Closed door pharmacy that provides drugs to skilled and long term nursing facilities.

• Point of sale adjudication for large volume of claims

• Very strong with insurance rejections and resolutions for HMO, Medicaid, Medicare, and private insurance

• Other tasks were patient registration, prior authorizations, and TARS.

• Worked on special projects as needed.

Insurance Payment Follow – Up 09/2008 to11/2008

American Medical Response Modesto, CA.

• Temporary assignment for tracking payment invoice information.

• Thoroughly investigated past due invoices and minimized number of unpaid accounts.

Paraeducator 09/200012/2008

San Joaquin County of Education Stockton, CA.

• Implemented various educational and physical goals according to each child’s needs.

• The classrooms I have worked in are autism, bilingual, pre – school programs, severely handicapped, and emotional and behavioral disabilities.

Paraeducator 09/2000 to 12/2008

Tracy Unified School District Tracy, CA.

• Supported special needs children to aid in approving their reading, writing, and math skills.

• Assisted in all grades and skill levels.

• Worked as a one on one assistant with some students for special situations of either medical or skill need.

Enumerator 04/2000 to 09/2000

U.S. Census Bureau Manteca, CA.

• Temporary assignment

• Captured accurate data for each household

• Solid understanding for reading maps

• Maintained composure when dealing with reluctant or angry people

Health Clerk 01/1996 to 01/1999

Los Gatos School District Los Gatos, CA.

• Attended to injured children’s first aid needs.

• Updated and filed health charts.

• Administered scheduled medications.

EDUCATION AND TRAINING

Medical Office Administration

San Joaquin Valley College Modesto, CA.

Certificate of Medical Office Administration

Medical Billing and Coding

MedTech Coding Resources Modesto, CA.

Certificate of Medical Billing and Coding

Liberal Arts

Niagara University Niagara Falls, N.Y.

Contact this candidate