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Medical Claims Workers Compensation Reporter

Location:
Sacramento, CA
Posted:
December 02, 2023

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Resume:

Mataniu Tualaulelei

**** ******* ***, **********, ** 916-***-**** ad1nbm@r.postjobfree.com

Professional Summary

Accurate, precise industrial reporter with over 20 years experience in the medical field. This experience has afforded me a well-rounded skill set that includes strong verbal and written skills which makes me a valuable asset to my organization.

Skills

Verbal and written communication

Self-starter

Proper phone etiquette

Time management

Good Customer Services

Team liaison

Attention to detail

Problem solver

Work History

Industrial Reporter, February 2000-March 1, 2023 (retired)

Kaiser Permanente Hospital - Occupational Medicine Clinic Sacramento, CA

Obtain all necessary patients, employer and carrier information needed to complete required industrial medical reports: Doctor's First Report of Occupational Injury or Illness, Form DLSR 5021 (''DFR'') and Primary Treating Physician's Progress Report, Form PR-2 (''PR2'')

From physician's notes, abstract information necessary to prepare industrial medical reports

Notify the appropriate Business Office personnel of industrial services not previously billed

Investigate notification of previously unidentified industrial cases from insurance claims administrators, Business Office personnel, employers, patients and others`

Review medical records to identify services related to the application

Create industrial medical reports necessary to support KP's lien claim

Medical Biller, October 1993-Nov. 1999

Genex Services, Workers Compensation Bill Review

Analyze, review and process payment on medical bills from providers, hospitals, ancillary medical providers Rehabilitation services and pharmacies, to significantly reduce costs to clients. Responsibilities include System entry, utilizing medical bill review software, adjudicate and process Workers’ Compensation Medical bills payment according to California Workers’ Compensation fee schedule and beyond.

Education

High School Diploma: 1985

Samoana High School Pago Pago, American Samoa

Sacramento City College 1988-1991



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