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Administrative Assistant Insurance

Fallbrook, CA
October 01, 2019

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Cathleen M. Perez

**** ********* *****

Fallbrook, CA 92028




Over seven years of experience working in the healthcare field. Thirty years’ experience as an administrative assistant prior to that. Proficient in: Microsoft Word, Power Point, Excel, Access, Outlook, and Internet. Knowledge of CPT Codes and ICD9/ICD-10 Codes and of HCFAA 1500 claim forms. Reliable, efficient, well organized with the ability to work well under pressure with minimal supervision and as a team player. Able to handle many projects at once while prioritizing tasks. Good ability to learn any computer software quickly. Type 50 WPM, 10 key, and excellent phone etiquette.


Acadia HealthCare

10/30/17 – 11/15/19

Benefit Verification Specialist

Responsible for the timely verification of insurance benefits provided via websites and/or calling the payor.

Obtain precertification and authorizations for services being rendered

Review and resolves prior authorization/precertification/referral issues that are not valid and contacts insurance carriers to verify/validate requirements to ensure accuracy and avoid potential denial.

Validates all necessary referrals/prior authorizations/pre-certifications for scheduled services are on file and shared with all appropriate staff and are valid for the scheduled services performed.

Ensure all account activity is documented in the appropriate system and shared with all appropriate staff timely and thoroughly.

Identify and forward potential reimbursement problems with the Billing Team.

Proactively interacts with Clinics and other appropriate staff sharing benefits, authorizations and eligibility.

Maintain confidentiality

experience in Billing Software

oNaviNet, Waystar, MDC, Methasoft, Tower

Ambry Genetics

1/10/13 - 10/2/17

System Process Biller

Contact patients and third party payers, collect payment, and resolve outstanding balances.

Review requisitions and all supporting documentation.

Perform insurance verification.

Review and enter demographic information.

Enter billing information into the system.

Identify and resolve problems in a timely manner.

Contact clients for missing information.

Review ICD-10 and CPT codes supplied for accuracy of billing carrier specifications.

Utilize multiple information systems and resources to research and enter data.

Prepare up doctor NPI information.

Doing appeal letters for insurance company.

Call patient doctor office and get medical records and LMN documents

Call insurance companies to obtain claim status for the patient.

Enter information you from the doctor; office and hospital after and enter them into billing software

Mail out claim forms with all documents to the insurance company

Maintain confidentiality.

Experience in collections and verify insurance benefits

Experience in billing software

oEZ Claim, Xifin, Telcor

Clarient –GE Healthcare Company


Temporary assignment thru Corestaff Agency

Enter medical, billing, and customer data into Clarient computer systems

Interface with customers to resolve conflicting information

Call patient regarding refund checks due to them.

Call insurance companies to obtain claim status for the patient.

Prepare adjustments, correct customer database information, and process Explanation of Benefits (EOB)

oPrepare account adjustments for Medicare billings

oProcess returned mail using TevixMD, XIFIN, or Laser Fiche to find the correct address

EDUCATION Larson Training Centers - Computer & Medical Claims Processing & Medical Terminology 7/99 – 12/99

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