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Data Entry Medical Billing

Houston, Texas, 77064, United States
September 27, 2019

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sivaiana duncan

***** * ******* **. ***# **** Houston, TX Phone: 208-***-****


Seeking a position with a Healthcare Company, that will offer stability and possible opportunity for growth.


Customer Service

Typing – 60 WPM

Data Entry


Microsoft Word

Microsoft Excel

Microsoft Outlook

Internet & Email

Medical Billing

Dental Billing

Medical Terminology

Dental Terminology

Medical Claims Examining

Dental Claims Examining


Medicare, Medi-Cal

CPT Coding

ICD-9 Coding



Reading EOB’s

HIPPA Guidelines


American Career College 2/2010 – 10/2010 Anaheim, CA

*Diploma: Health Claims Examining Medical Billing

*Certificates: Honor roll, Perfect Attendance

United Educational Institute 4/1998 – 11/1998 Santa Ana, CA

*Certified: Medical Assistant

Santa Ana Valley High School Santa Ana, CA *Diploma: High School Diploma


Collections Insurance Specialist

Cenikor Foundation - Houston TX - March 2019 to July 2019

Worked aging accounts and clean up AR

Worked fast pace productivity and quality was expected and met

Worked accounts accurately and timely to increase revenue cycle.

Check emails for assigned tasks for the day

Worked both commercials and self pay collections

Worked both in - network and out of network claims

Prepared and submit our own appeals for denials if need be.

Worked remotely from home on assigned days independently

Initiate and prepare refund requests of recoupment or self pay refunds.

Worked on a in house system called Welligent

Worked on EOB s daily to update status

Notated accounts and rupdated resolved claim issues to better the productivity

AR Collections Specialist/ Claims Analysis

Ascent Revenue Management – Houston, TX – September 2016 to June 2018

Work AR for two large clients involving billing for Gastroenterologist and Liver Associate LAB and Gessner Anesthesia Associates

Billing claims out of a network for this one particular client

Calling Insurance to get claims reprocessed with in network.

Appeal claims on patient behalf.

Worked self-pay

Adjustment made to patient accounts, when insurance pay 80% on a claim.

Dealt with patients, explaining how claim was processed. Why the claim went out of network.

Also answer phones, took patient payment on patient accounts.

Work on nextgen System.

Collections Specialist

Alegis Revenue Group Med Data, LLC - The Woodlands, TX – 06/2015 – 06/2016


Worked different accounts every day.

Returned accounts, initials, follow-ups

Done Appeals know how to put one together

On the phones following up on claims

Check status of a claims.

Verified insurance. Also following up on Appeals. Worked in many different hospital systems

Resolve account issues

Make sure my initial would be in great details for follow ups.

Always on phone with insurance company to resolve matters.


Making sure the client is happy. The accuracy and timely manner of the work I did at Alegis is a big impact to them

Skills Used

I have a strong understanding of a billing and coding background. That gives me knowledge and understanding of knowing how to follow-up on claims or Appeals. Knowing how to put an initial together. Calling and verifying eligibility and dealing with insurance companies over the phone.

Enrollment Auditor

Blue Cross of Idaho 10/2014 – 03/2015

Provide accuracy data entry

Verify accuracy of data entry correct any miss findings

Knowledge of ten keys and can use with accurate speed

Knowledge of system used like SAM and Facets to complete work

Provide good customer service in updating and keeping good records

Prepare detailed reports on audit findings

Examine and evaluate financial and information systems

Ensure system reliability and data integrity

Review data about material assets, net worth liability, capital stock and income

Collect and analyze date to detect deficient controls, duplicated effort, fraud, regulations and management policies

Data Entry/ Medical Biller

Magella Medical Group Inc 04/2011-06/2013

Enter patient information on data base, charges for high risk pregnancies, bill PPO, Medical and Medicare insurance also code procedure performed on patient, resolve patient billing problems

verified insurance and patient eligibility, Conduct self in accourdance with HPA’s employee manual, request patient information or chart from hospital, operate a multi-line telephone

Responsible for collecting, posting and managing account payments, billed Blue Cross, Blue Shield, Aetna, PPO and HMO also balance accounts in the end of the day

Submitting claims, follow up on claims with insurance company, processes payments

Answered patient questions, clerical staff and insurance companies and sometimes also schedule patient appointments. Prepared, reviews and send patient statements

Health Claims Examining Medical Billing (internship)

Bienestar Medical Center 10/2010-11/2010

Greeted and took patient information, answered phones in a professional manner

Scheduled appointments, filed, looked up patient, billing insurance, PPO, Medicare, Medi-Cal

Billing for birth control, STD’s, blood test and pregnancy testing

Worked front and back office, data entry, Microsoft Word, Microsoft Excel, Outlook

Medical Terminology, CPT Coding, ICD-9 Coding, UB-04s, HIPPA Guidelines

Checked for eligibility of patient, collection and coding and 10-keys

Executive Assistant/ Receptionist/ Medical Device

MiCardia Corporation 09/2009-06/2010

Greeted and directed clients and customers, Purchased office supplies as needed

Assisted with staffs assessments and preparation for board meetings and presentation plans

Answered phones in a professional manner, Scheduled appointments or travel arrangements

Data Processing / Business Office 11/2006-06/2008

Bristol Park Medical Group

Processed about 100-200 fee tickets per day, worked well within deadlines demanded of me

Made sure patient is covered with medical or insurance on fee tickets

Worked with insurance companies like Blue Cross, Blue Shield, HMO’s PPO’s

Processed fee tickets for radiologists for x-rays, Knowledge of CPT codes and medical terms

Medical Assistant/ Receptionist

Hoag Hospital 09/2004-10/2006

Provided patients with information and support, well organized and detail-oriented

Answered multiple phones and performed data entry, filing, faxing and other clerical duties

Assisted with insurance billing, Reports to billing supervisor or named Office Manager

Familiar with Workers Compensation, posting and managing patient charts

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