Customer Service Medical

ROTUNDA BROWN

**** *** *** *******, ** ***** ~ ************@*****.*** 510-***-**** CELL PHONE

SUMMARY OF QUALIFICATIONS

I am ambitious, with a solid background of progressively responsible customer service and administrative

experience. I possess excellent communication, negotiation, and interpersonal skills with a reputation for forming

productive partnerships and fostering collaborative efforts toward common organizational goals. I have proven

success at representing organizational interests. I am highly analytical, innovative, organized and independent

self-starter who also excels at team-building, leadership, and staff motivation.

EDUCATION

Everest College- Hayward, CA

Medical Assisting Diploma 2007

Merritt College- Oakland, CA

Certified Nurse Assistant 2002

Alameda Adult School- Alameda, CA

General Education Diploma 2012

PROFESSIONAL EXPERIENCE

RUBIXIS INC OCT 2013- PRESENT FREMONT, CA

A/R Specialist/Cash Poster

• Manage daily cash application of payments from lockbox, ACH, and Credit Cards.

• Provide proficient and accurate Payment Posting and Cash Reconciliation.

• Demonstrate knowledge of third party payment methodologies and documentation.

• Post manual and electronic insurance, client, collections, and patient payments.

• Ability to read and understand rejection/denial codes via paper and electronic EOB’s and

remittance files.

• Follow up with insurance payers, client, and patients when needed.

• Submit, request, and issue insurance, client, and patient refunds.

• Reconcile credit balance accounts

• Submit paper and electronic claims to both Government and Commercial Payers

• Demonstrate knowledge of the payment adjudication, denial, and appeals process.

• Provide webinar and hands-on training to staff.

• Process and offset payments, Credit and Debit Memos on a daily basis.

• Participate in the month end process and audit of Accounts receivable.

ROTUNDA BROWN PAGE TWO

ALAMEDA COUNTY MEDICAL CENTER (OFFICETEAM) NOV 2011- OCT 2012 SAN LEANDRO, CA

State Disability and Worker’s Comp Coordinator (Temporary Position) August 2012-October 2012

Purchasing Clerk, Purchasing/Materials Management (Temporary Position) July 2012-August 2012

Administrative Assistant, Rehabilitation Administration (Temporary Position) Nov 2011-July 2012

• Process Purchase Requisitions

• Coordinate meetings and maintain calendars for Dept. Heads.

• Billing, Coding and Charge Entry for physicians.

• Act as a Liaison between EDD and patients; interview patients to review eligibility for SDI

• Reviews claims for payment for completeness, accuracy.

• Participate in departmental meetings and trainings.

• Coordinate Disability, PFL, and FMLA forms for patients

• Coordinates purchasing activities; reviews requisitions for completeness and accuracy; ensures

appropriate coding and availability of funds.

• Retrieve and complete Doctor’s 1st Reports

• Process Worker’s Compensation Claims

• Responds to patients, their physicians, and authorized representatives regarding State

Disability.

CALIFORNIA SERVICE BUREAU FEB 2011- NOV 2011 NOVATO, CA

Medical Billing and A/R Specialist, Insurance Follow-up Unit

• Utilize knowledge of Medicare, Medi-Cal, Worker’s Compensation and Commercial/Managed

Care (HMO, PPO, POS, etc.) to timely and accurately process patient account billings to

insurances.

• Manage account receivables for multiple entities.

• Conduct follow up for commercial, managed care contracts, stop loss and self-pay

inpatient/outpatient services.

• Work credits account and send refund request daily.

• Send appeals as needed.

• Manage client lists and make sure they are current.

• Ensure that all adjustments were processed correctly.

• Provide cross training to representatives.

• Ability to read and understand rejection/denial codes via paper and electronic EOB’s and

remittance files.

ROTUNDA BROWN PAGE THREE

CALIFORNIA PACIFIC MEDICAL CENTER (AEROTEK) JAN 2009- MAR 2009 SAN FRANCISCO, CA

Medical Data Entry Clerk, Surgery Scheduling Department (Temporary Position)

• Input surgery cases and patient information in detail.

• Scheduled patients surgeries via fax and telephone

• Prepared mailers and correspondence.

• Verified patient’s identity and insurance coverage.

• Communicated with medical professionals and insurance company personnel to expedite

patient eligibility.

CHABOT UROLOGY NOV 2007 –FEB 2008 CASTRO VALLEY, CA

Medical Assistant

• Room patients and patient charting.

• Administered injections.

• Assisted with minor surgeries

• Completed registration for patients

• Documented referral request for coordination of care

SOFTWARE/ CODING SKILLS

Microsoft Office Windows Office (Excel, PowerPoint, Word, PeopleSoft), MS4, CareMedic, Series, Paragon,

CUBS Passport, DDE, UBO4/1500 form billing(electronic and paper), HCPCS coding methods, ICD-9 Diagnosis

coding, CPT procedure coding.

*References available upon request

Contact this candidate