Medical Billing

Sophia Gomez

**** ********* **. ******, ** ****7

Cell: 510-***-****: *********@*****.***

Professional Summary

Enthusiastic individual with excellent people skills and a dedicated work ethic. Strong attention to detail and extensive knowledge of Electronic Medical Records(EMR). Looking to enhance my professional skills all while building a long-term career with opportunities for career growth.

Skill Highlights

Professional Experience

Application Analyst

November 2012 to Current

Alta Bates/Summit Hospital East Bay Region - Oakland, CA

Providing routine application and technical support for the product line, in addition to providing triage and troubleshooting assistance to customers.

Monitors the system for data quality, efficiency, operation, and data integrity and appropriately escalates issues/problems. Assists in system analysis, design, development, documentation, and configuration as well as testing and training of the product. Allowing the electronic data and communications available for Sutter Health employees, providers and patients to support the health and well-being. To enhance patient care and safety.

Oversee Rightfax,LabCrop(Cancer Center) & AMB LabCorp,CPN Flowsheet Devices, Charges,GE Muse, Aria Scheduling, Radiology, Sunquest Labs, Escription, Hyland Onbase scanned documents into patients charts. All are a part of EHR (Epic) which are also a part of the Epic Bridges queues as well as troubleshooting the interface passing the messages through to the charts. I also provide support with HL7 codes and experienced with Bridges error logs. Identifying root causes of issues in the interface and providing a resolution.

Provided Sutterlink access to physicians and medical staff for remote token access to Epic for patients charts and treatments.

Facilitates Virtual Training on a weekly basis for all new and current employees at Sutter Health. This consist of setting up being there for troubleshooting, having the course materials they need giving and assessment at the end of their training and having constant communication with the trainers online.

Provides 3rd party vendors along with MD’s, RN, LVN, MA’s and all office staff and billers access to EHR Epic system to give pt care. Request forms filled out within my approval and access of correct templates due to what their specified duties are I then grant access and assign them their Mobile Sutterlink access.

Monitor and support the Access Queue in Remedy- providing support and creating/ modifying user accounts and their access within the epic system. Using BMC Remedy IT Service Management program.

Provider Relations/ Billing Coder

December 2011 to November 2012

Safeway Corp. - Pleasanton, CA

Working in the Risk Management Dept for Workers Comp. Dealing with Provider Relations overseeing all projects.

Updating & Maintaining the MPN Database (Medical Provider Network).

Distributing Letter of Agreements & Credentialing Applications to all Doctors and Medical Facilities, as well as Termination letters.

Also working as a Bill Coder for the Workers Comp Dept, review and analyze all bills & invoices that come thru the dept. Checking dates CPT codes making sure the invoice is properly coded in the correct category and applied correctly.

Also gathering any and all W9 requests and filing out Vendor Maintenance forms completed and turned in. To complete the coding of the invoices When needed.

Billing Specaialist / AR Follow-up

June 2011 to December 2012

Berkeley HeartLab Inc.- South San Francisco, CA

Medical Billing Specialist: Performing Accounts Receivable duties in Medical Billing. Mainly dealing with many different insurances. Including ( Anthem Blue Cross, Blue Shield, Medicare, Tricare, UHC, many other insurances.

Consists of calling insurances getting proper account info, updated insurance information.

Processing payment information.

Appealing any and all issues with patient’s accounts, processing bill cycles, adjusting any accounts needed.

Billing Clerk

May 2006 to January 2010

Kaiser Permanente – Union City, CA

Responsible for overseeing the Bay Area Skilled Nursing Facilities including (Castro Valley, Fremont, Hayward, San Leandro, Union City).

Including processing claims such as Lab Bills, Room and board stay and verifying medical coverage for patients vendors and doctors as well as nurses.

Also verifying skilled days the patients have left of skilled coverage.

Weekly reports for patients at the Nursing facilities as well as monthly reports.

Processing bills includes, data entry, batching, closing out and recording then sending off to Regional offices for payment.

Also assisting in daily phone calls no matter what the situation may be. Assisting co-workers with other tasks such as Admissions for the patients when they are sent to a Skilled or non skilled nursing facility.

Alerting the Doctors, Nurses, NP, Case workers as well.

Admin Assistant/Dept Secretary: HPRS Licensing

October 2004 to May 2006

Kaiser Permanente - Oakland, CA

Support all staff, schedule meetings.

Coordinate all meetings and luncheons. Keep up manager's calendar.

Processing efilings for the DMHC,

Oversee all expense reports for many managers plus travel for all staff. Keep all staffs records for time off requests and for payroll as well. Any and all other projects needed.

Any urgent request that the staff or management. Check requests, billing for the dept.

Education and Training

Associate of Science: Business, 2015

Las Positas College - Livermore, CA

Certification: Medical Assistance, 2003

Boston Reed - Fremont, CA

High School Diploma: 1999

San Lorenzo High School - San Lorenzo, CA

Contact this candidate