Insurance Medical

Margaret Tafoya

**** * ******* ** *** *** LAS VEGAS, NV 89147 760-***-****, ***********@*****.***

OBJECTIVE

TO FIND LONG TERM EMPLOYMENT IN A TEAM PLAYER COMPANY. TO BRING POSITIVE IDEAS AND

MY SKILLS IN A POSITIVE ENVIRONMENT.

3/5/2014 To Current UMC Hospital-Financial Field Representative Las Vegas, Nevada

Workman’s Compensation Representative/C4’s & claim processing

Time sensitive Workman’s comp claims. Must process within 3 days. Direct contact with Third party insurance

Companies. Must handle claims from beginning to send. Direct contact with DIR to locate TPA’s, Contact for

Claims numbers, adjusters & pertinent information. Also billing out of state Medicaid for multi states for patients

coming to Las Vegas for illnesses, assaults, etc. Software used includes HPN, AS400, Chart One, Relay,

Sessions and Star Navigator. Must conduct myself in a professional team playing environment. Patient contact

Is also involved as they come to UMC regarding billing and completing C4 forms. Enormous amount of investigation.

EXPERIENCE

3/1/2013 to current Branson Medical Group Henderson, Nevada

Medical insurance biller

• Medical billing, aging, follow up, patient calls in a multispecialty practice. Working on 2 different software

programs, Eclinical Works and Medisoft. Working and familiarize with clearing house, Navicure to correct

billing errors, resubmit and get claims paid. Extremely busy office in all type of Doctors, surgeons,

laboratory claims. A/R and now promoted to Administrative Asst. doing credentialing for

• approximately 15 Doctors. Requires organization, excel spreadsheets, timely issues on a day to day

• basis. Extremely stressful but very rewarding. Workman’s compensation claims and follow up in a timely

manner. Billing supervisor-Stephanie Saxon 702-***-****

august 2012 to March 2013 Mohammed Reza Ahmadinia, M.D. Apple Valley, CA 92307

• MEDICAL INSURANCE BILLER

• Working in extremely busy OB/GYN office using Tel Comm billing software. Data entry, aging specialist,

collections specialist. Collecting prepays, verificiation of insurances, HMO referrals, timely claim

processing and follow up and speaking to patients regarding financial obligations. Keep up to date with

• all insurance rules. Billing supervisor-Gina Lara 760-***-****

Apple Valley, Ca 92307

3/1/2012 to 8/1/2012 High Desert Cardiopulmonary Inc.

Medical insurance biller

• Hired in this multispecialty practice, heart and lungs. Hired to do aging and follow up of old unpaid claims.

This practice had a A/R that was extremely high. I worked hard to get claims paid. This practice also

included a sleep disorder practice and many procedures required operative reports and prior authorization. I

accomplished learning and getting these claims paid. I created inventory, organization and team building

with this company and gained great friendships. Worked with Medisoft and going into E Clinical. Office

manager-Natalya Herrera 760-***-****

Spokane, WA

7/1/2000 to 12/1/2011 Northwest OB/GYN

Financial coordinator

• Long term employment, almost 12 years for this large OB/GYN office and surgical suite. 150 patients seen

on a daily basis. Nine OB Doctors, 9 mid-level providers, midwives. We were very proud to have a

excellent A/R history. I spoke to all patients regarding their financial obligations and helped them seek

• Medical coverage in critical situations. I did coding for our surgical cases, determined allowables with

insurance companies. Precerted inpatient stays, CT scans, clinical review. I loved this team playing practice.

We all worked together as family. Supervisor-Julie Elledge 509-***-****

EDUCATION

H.S DIPLOMA-VICTOR VALLEY

VictorVille, California

H IGH SCHOOL-1977

• Certificate in Medical Terminology, Victor Valley Community College, 1978 VictorVille, California

REFERENCES

Ellie Heppner-Coworker & friend for 12 years, Spokane, WA. 509-***-****

Cheryl Hogan-Coworker & friend for 14 years, Spokane, WA. 509-***-****

Jodi Peone- Friend for 22 years, Spokane, WA 509-***-****

Contact this candidate