Personal Summary:

I’m an ambitious, enthusiastic, talented woman with a strong background in Medical billing administration, dispatching, aan a class B driver with exceptional driving experience (bus an ambulatory field). I am intermediate /advance in Microsoft Excel, PowerPoint, Word, Lotus, Trauma Soft; w Experience working under pressure in an analytical environment. That involves research, dispatching, security, patients and transportation. I am currently looking for an employer that offers a professional friendly work environment, with the opportunity of growth, where my skills and abilities can be utilized.

Skills Summary:

Pre/ Post trip Brake endorsement Passenger endorsement

Class B license Fixed Route Driver Commuter Driver

Transporting passengers Dialer Ride/ Scheduled Pickups Bus Driver

UB92/ CMS-1500 Scheduling Electronic / Manual Claims

Workman’s Compensation Medical Coding Attorney/Liens

Research and Reconciliation Proof Reading Medicare Downloads (RADS)

Coordination of Benefits Adjuster Payment Posting

Claims Processor Medical Records Accounts Payable Receivable Utilization Review Eye for Detail Prioritize time accordingly

Dispatching (CCT, BLS, ALS) Transportation Discharge

Education:

American River Community College Sacramento, California

EMS program (Jan 2020)

University of Phoenix (Current) Sacramento, California

BS Health Information & Medical Management

Charles A Jones Skill Center

Administration Medical Billing/Coding Sacramento, California

Employment:

Dispatcher

Camden Security February 2020 – Current

Monitor and authorize entrance and departure of employees, visitors, and other persons to guard against theft and maintain security of premises.

Write reports of daily activities and irregularities such as equipment or property damage, theft, presence of unauthorized persons, or unusual occurrences.

Call police or fire departments in cases of emergency, such as fire or presence of unauthorized persons.

Answer alarms and investigate disturbances.

Circulate among visitors, patrons, or employees to preserve order and protect property.

Patrol industrial or commercial premises to prevent and detect signs of intrusion and ensure security of doors, windows, and gates.

Escort or drive motor vehicle to transport individuals to specified locations or to provide personal protection.

Answer telephone calls to take messages, answer questions, and provide information during non-business hours or when switchboard is closed.

Dispatch / Non-Emergency Driver April 2019- January 2020

Sacramento Valley Ambulance

Dispatching

Receive, prioritize, coordinate and dispatch Ambulance calls for service for ALS, BLS, CCT and Flight crews in a swift and proper manner using our Communications Center Dispatch Software.

Requests will be taken from hospitals, clinics, medical assistance companies, flight teams or related entities.

Dispatched coordinate the transportation requests an send the most appropriate unit based on unit availability, unit location, travel time, etc.

Dispatched and call taking for Sacramento Valley Ambulance crews to both the emergency and interfaculty setting, including emergency and private callers.

Operate tracking, radio or cell phone communication equipment to monitor the status of field personnel and units.

Transportation Driver

Transport clients with special needs and disabilities, including those needing wheelchair assistance in a timely manner.

Picked up patients from doctor appointments, skilled nursing facilities, hospitals, discharges

Utilize GPS to locate pick up and drop off locations.

Ensure vehicles are cleaned and maintained in good working order; responsible for reporting repair needs to supervisor.

Interact with clients in a professional, compassionate, and friendly manner.

Class B Bus Driver March 2018 – April 2019

MV Transportation

On-time passenger pick-up and delivery.

Conducting pre and post trip inspections to ensure proper operating condition of vehicle and on-board equipment.

Ensure safe and clean vehicle condition at the start and end of each shift.

Communicating effectively with dispatch or central office via two-way radio.

Providing excellent customer service including assistance in boarding and de-boarding, supplying information, and responding appropriately in the event of emergency.

Employing all techniques of defensive driving to minimize risk.

Maintaining a safe work area and a focus on safety to reduce the opportunity for injury to self or other employees.

Eligibility Rep II-OPS- (Temp) October 2016- Mar 2017

Health Net (Centene)

Processed and maintained eligibility information for routine individual and/or employer groups under general supervision

Maintains accurate eligibility records for individuals and/or assigned employer groups.

Process all enrollments; plan changes, and disenrollment transactions

Reviews aging to determine delinquent accounts, membership reconciliation issues from premium issues. Produces and distributes delinquent notices to members.

Provides daily support on incoming verbal or written correspondence enrollees regarding eligibility and processing status

Communicates policies, procedures and benefits to employees, enrolled members or, if applicable, employers. Interacts with staff in other departments to clarify and resolve eligibility problems presented by members.

Provides cross training and back-up assistance to other enrollment groups.

Provides support within service operations as needed such as Membership Accounting.

IFP Billing- Member/ Group Processor – July 2013 – May 2016

BlueShield of California – (Contract)

Maintained and reconciled subscriber records and researches root cause of various types of billing discrepancies.

Maintained and reconciled reports that identify billing updates or errors that need to be corrected in our system of record.

Identified and researched discrepancies affecting eligibility and/or allocations of payments

Monitors delinquency and money allocation

Notifies supervisor of any reporting or payment deviations or discrepancies

Identify issues and make corrective action

Working Combined Bills- Bill Outs / Med Sup / Facets

Transferring funds from group and family accounts

Detailed research of subscriber’s information and needs basic knowledge of Health Care Reform.

Comprehensive knowledge of Windows based tools (ERM, SSEP, Facets, Documentum, Service Link, Excel, Access, and Word)

Hospitalist Medical Technician (Floater) - August 2011- December 2013

Dignity Health CHW Hospital – Temp

Create Hotlist & Daily numbers for Hospitalist on a excel spreadsheet

Created notification in Scripts for MMG Hospitalist

Ran daily reports in MS4 regarding admits & discharges

This report was also used to keep track of patients care.

HCC was used to keep up with doctor’s rotation & assigning patients to Hospitalist

Work with Funeral homes regarding death certificates, which is time sensitive. If I needed to meet or locate doctor, every way was utilized ( myairmail is most effective, which is a via email method for pagers

This system is used to alert Doctor’s regarding patient care (admits / discharges)

Once spreadsheet was created, this list was via emailed and faxed to different hospital units

This report was used to make Hospitalist aware of capped patients and track patients that have been discharged and admitted.

Faxed important documents at Hospitalist request

Faxed prescriptions (request/clarifying issues) back to pharmacy and DME providers

Locating Hospitalist for immediate discharges

Working in a fast pace environment

Being able to communicate with Hospitalist in an effective manor

Prioritizing time and ability to make changes fast & effectively is a requirement that I upheld

MSP Patient Biller III/ Follow-up March 2009- June 2012

UC Davis Hospital Per Diem

Use Invision, Caremedic, Onbase, Palmetto, Web or DDE to research and verify payments, patient information, adjustments on accounts.

Billed claims according to Medicare Guidelines

Billed MSP Claims and covered all follow-up work

Cross-billed

Posted Adjustments

Wrote off balances according to Medicare pmt, timely filling an or payments made on acct

Review all charges and procedures

Reviewed EMR

Request certification for Physical, Occupational, Speech (ENTST &PMRST) Therapy Certification

Construe and understood complex contract terms

Researched missing claim information via DDE, Invision, FM00, Web, Intellisource, Palmetto, EMR, Caremedic, Stockcamp

Verify receipt of necessary authorizations.

Match payments to charges using EOB or Remittance Advice (RA)

Determine contractual allowance per exact charges (DRGS, Revenue Codes, HCPC’s, Provider type and type of service.

Balanced/Adjusted claims accordingly

Made appropriate adjustments

Corrected misapplied payments or underpayment

Resolved issue’s regarding denials with supporting documentations

Kept record of all claims worked on Excel

Contacted the following (insurance companies, patients, departments within UC Davis) to determine the best resolution regarding patients accounts.

Reference Available upon request

Contact this candidate