Service Representative Medical Billing

K A T H R I N M A Y P . T I Q U E

**** ******** ***** *** ****, CA, 95148

CONTACT #: 408-***-**** – EMAIL: *************@*****.*** OBJECTIVE

An organized and responsible experienced professional in the medical field with comprehensive medical billing skills seeking a position to gain more opportunities, knowledge and experience. EDUCATION

INDEPENDENCE HIGH SCHOOL

SAN JOSE, CA- GRADUATED 2006

WORK EXPERIENCE

Claims Processor I- Billing Department January 2019-September 2022 Sutter Shared Services Roseville, CA

System: Epic

Verifies insurance coverage, setting up the correct payor and resubmitting the claims for processing.

Working on different workqueues to help out with the inventory for other functions such as Retro Review, Charge Review and Claim Edit to meet month end/year end goals.

Updating and determining which insurance is showing primary, secondary and tertiary to bill the correct payor.

Coordinates with insurance to obtain eligibility date and claims address.

Collaborates with senior management for special projects.

Reaching and exceeding more than assigned capacity goals on a daily basis. Patient Service Representative – Pre-Registration Department August 2015 to 12/31/2018 Palo Alto Medical Foundation Sunnyvale, CA

System: Epic

Reaching daily production goal to ensure that work has been completed for the day.

Verifying insurances making sure they are active and contracted.

If there is any discrepancies regarding patient’s insurance, contact patient to have it situated.

Participated in project for HANC – transferring patient’s information from Alteer into Epic and verifying insurance coverage.

Worked on pre-registration and charge review workqueues.

Participated in project for PPO authorization- checked if authorization would be required for an outpatient surgery then process the referral. Made sure insurances are set up correctly. Patient Account Representative December 2006 to August 2015 Physical Rehabilitation Network Santa Clara, CA

System: Next Gen

Scheduled patients’ appointments, checked patients in and out of each appointment.

Helped transition old system Intergy to Next Gen and was a Super User. Transferred all of patients’ information from the old system to the new system.

Managed front desk duties such as filing paperwork, obtaining authorizations, phone calls, faxing documents to the necessary locations, collecting patients’ copay or deductibles.

Registered New Patients and verified insurances (making sure plan is contracted). K A T H R I N M A Y P . T I Q U E

2201 FAIRMONT DRIVE SAN JOSE, CA, 95148

CONTACT #: 408-***-**** – EMAIL: *************@*****.*** Professional References:

-Mark Mena (Former Manager) 650-***-****

Palo Alto Medical Foundation

-Ann Landero (Former Supervisor) 408-***-****

Palo Alto Medical Foundation

-Anna Casem (Former Director) 408-***-****

Physical Rehabilitation Network

-Danielle Guzman (Current Supervisor) 916-***-**** Sutter Health

Contact this candidate