Medical Insurance
Resume:
Steven T. Nguyen
Houston, TX 77040
Cell: 281-***-****
SUMMARY
Twenty one years of computer-oriented experienced in Word, PowerPoint, Excel, Adobe
and Outlook, and as lead medical claims processor.
Strengths include:
1. Work under pressure
2. Flexibility
3. Team work
4. Quality and accuracy of work
WORK EXPERIENCE
Title: Medical Claims Processor
Christus-USFHP 2707 N Loop W Houston, TX 77008 had worked from 7/16/2001 to
12/06/2016
Memorial Clinical Assoc., 8800 Katy Freeway Ste 210 Houston, TX 77024 had worked
from October, 2000 to January, 2001.
North American Medical Management 1235 N Loop W Ste 450 Houston, TX 77001 had
worked from October, 1999 to October 2000.
Huntington Provider Group 70 S Lake Ave., 8 Pasadena, California 91101, had worked
from 5/1991 to 9/1999
SELECTED ACCOMPLISSHMENTS
As senior claims examiner who is responsible to process all type of claims.HCFA-
1500, UB-2, DME, HPCPS, EDI, dental claims and adjustment.
As a HVAC technician at Jeneer, LLC, I has known very much how to install
ductworks, seal furnace and evaporator together by myself, I understand Type I, II,
III how they work, I know how to do pump down, vacuums, leak detections, repair,
recovery, brazing and troubleshooting etc…..
Position an auditor in the past was responded to audit the hospital claims and professional
claims with high dollar amounts, basically is underpaid and paid wrong contracts, audit
cases involving overpaid claims and initial appropriate action in accordance with
established policies and procedure etc….
Knowledgeable in HMOs/PPO Medicare and private insurance.
Able to read and technically interpret different contracts.
Well informed in medical terminology, ICD-9 and CPT coding.
Successful self-starter who can work with high degree of flexibility and adapt to
constantly changing and revised guideline and computer programs changes.
Attained high level of performance and productivity standard and quality of processed
claims.
Demonstrated skill in analyzing, applying and communication policies, procedures and
regulations relevant to functions performed.
Respond to complex difficult, or none-routine written inquires received from IPAs,
Medicare group, Providers, Hospital and Members.
SPCIALIZED TRAINING
Heating an A/C, specializing on troubleshooting
Heating and A/C skills on electric and gas
and the most common refrigerants have used in A/C are R-22, R-134A, and R-410A
Medical terminology
Computer skills
10 key by touch
EDUCATION
- HVAC-current student at Lone Star College from March, 2014 to present, I am about
completion the courses on both studying and lab works and will be certified.
-A.A. Degree graduated at Pasadena City College, California in 1989
-Completed twelve months of Computer Information System at Wilshire Business School
in 1991.
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