Customer Service Medical
Resume:
DaVina Brown
Oakland, CA ***03
Ph: 404-***-****
@: *********@*****.***
Summary
Experienced medical biller with over 10 years of experience. Also several years of data entry experience, typing @ 50 wpm & alpha-numeric data entry @ over 10,000 kph. I am knowledgeable of various databases including EPIC (EMR), Health Connect, MediSoft, OfficeWorks & ePremis. I am proficient with Medical Terminology and I am HIPAA Certified. Looking for a position in medical billing/administrative in a healthcare setting.
SKILLS
Microsoft Outlook
Intermediate
Benefits Verification (Availity, Navinet, United Healthcare, BlueCross/BlueShield,
Alameda Alliance, MediCal, Aetna, Medicare, & others)
Expert
Database Management
Intermediate
Data Entry
Expert
Customer Service
Expert
Medical Terminology
Intermediate
UB92 & CMS1500 claim forms
Expert
Understanding of CPT, ICD9, and HCPCS codes
Intermediate
Knowledge of Worker's Compensation, HMO, PPOs, IPAs, Medicare, Medi-Cal, and Collections
Intermediate
WORK EXPERIENCE
Insight Global San Francisco, California Jan 2015 - March 2015
Reimbursement Counselor
Ÿ Contacted various (private/commercial/government) insurance companies to verify patients coverage and benefits for specialty medication
Ÿ Use set guidelines to determine if patient qualified for the Patient Assistance Program
Ÿ Update/enter new benefits info in database
Ÿ Supported PAP counselor in Eligibility Review and/or Reassessment of the Patient Assistance Program
Ÿ
Josephine's Professional Staffing Santa Clara, California . Aug 2014-Present
Medical Biller
Ÿ Posted charges and payments into Medisoft
Ÿ Transmitted claims to clearinghouse
Ÿ Prepared month and year end closing reports
Dr. Suresh K. Sachdeva - Pediatrics San Ramon, California April 2014 - July 2014
Medical Biller/Receptionist/Data Entry
Ÿ Performed filing and documentation for medical records, lab reports, patient requested medical charts
Ÿ Scanned patient requested medical reports
Ÿ Filed bills and files including pharmacy requests and other information. Utilized both scanner and physical filing for information tracking.
Answering phones, scheduling appointments, collecting copays/coinsurances and form fees, verifying eligibility/benefits with a variety of insurance companies
Collecting new patient information, preparing patient charts, processing medical records for transfer, processing HEDIS requests
Posting payments/copays, sorting/processing incoming mail, scanning super bills, submitting claims for payment to various insurance companies
Insight Global, LLC Concord, California November 2013 - January 2014
Desktop Technician
Troubleshooting & Mapping
Building PC's & Performing TDR(Technical Dress Rehearsal)
Validation testing
Technology testing
Staffmark Employment Services Union City, California March 2013 - October 2013 Data Entry
Processed payments for approximately 60,000 checks paid to the IRS
Document and enter data into database
Kaiser Permanente Oakland, California December 2005 - December 2012
Claims Editor
Ÿ Audited, analyzed, and corrected medical claims for approximately 300 Worker's Comp, Commercial, and Government claims
Ÿ Abstracted and entered data in Epic (EMR), Health Connect, and ePremis EMRs
Ÿ Located pertinent information needed to submit clean claims using Health Connect, Bedrock, and Mainframe
Communicated best practices to local business/medical office trainers and managers for submitting clean claims to payors
Ÿ Assisted in various OT projects
Bayside Medical Group Dublin, California March 2005 - November 2005
Coding & Charges Rep
Ÿ Entered and batched payments for medical claims from EOB's
Ÿ Logged charges into system
Ÿ Verified insurance coverage
Ÿ Prepared claims for submission to insurance companies
Ÿ Reviewed EOB's for any follow-ups and/or appeals for denied/rejected claims
Externship-Bright! Now Dental Oakland, California October 2004 - December 2004
Medical Insurance Billing & Coding - Externship
Pulled, filed, and sorted charts numerically
Answered phones to schedule, cancel, and confirm appointments
Berkeley YMCA Head Start Berkeley, California September 2003 - March 2004
Data Entry Clerk
Ÿ Prepared reports, data entry, and reduced three months of backlogged data entry in three weeks
Ÿ Managed company database and files
Ÿ Conducted family orientations
Brick Housing Management, LLC Concord, CAOctober 2001 - April 2003
Human Resources Specialist
Ÿ Benefits administration, training and development; process new hire and termination paperwork;
Ÿ processed injury claims; coordinated/scheduled meetings, travel arrangements, and office relocations, documented and update policy manuals;
organized and maintained employee' personnel and time reporting records; ordered, distributed, and managed office supplies; prepared payroll reports and 18-21 pg. rental publication weekly, and other administrative tasks.
Brick Housing Management, LLC Concord, CA May 2001 - October 2001
Administrative Assistant
Greeted customers/applicants; prepared application/staffing packets and weekly payroll reports; completed employee reference checks
Ÿ Collected and monitored employee timesheets
Ÿ Issued paychecks
Ÿ Typed correspondence; distributed both inter-office and regular mail.
Metro One Telecommunications Alameda, California May 2000 - November 2000
Customer Service Representative
Ÿ Answer up to 400 incoming calls per day via headset and computer in an in-bound call center
Provide phone numbers, connecting as requested, providing driving directions using a computer mapping system, and assisting other CSR's in locating information as needed.
EDUCATION
Vocational, Medical Insurance Billing & Coding, Certificate May 2004 - December 2004
Bryman College Hayward, California
Castlemont High School Oakland, California June 1993
General Education
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