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Reimbursement, knowledge of insurances and eligibility

Location:
Victorville, CA
Posted:
April 13, 2023

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Resume:

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TISHA ROJAS

***** ****** **. ***********, **. 92394 760-***-**** adwi1j@r.postjobfree.com

OBJECTIVE

Obtain a position of office support assistant within a general business or medical office environment. SKILLS AND QUALIFICATIONS

Friendly, highly motivated and energetic attitude

Ability to successfully supervise multiple projects simultaneously while meeting strict deadlines

Culturally sensitive team player with reliable work ethic

Strong organizational and analytical skills, efficient and proactive

Proficient in hospital policies and procedures

Typing speed of 40 WPM

Proficient in insurance eligibility websites; IEHP, Molina, Navinet, and Passport

Proficient in McKesson, MPF, Quadramed, Data Systems Group, and Kofax EDUCATIONAL BACKGROUND

Bachelors of Science, Health Care Administration- April 2013

Associate of Arts, Health Care Administration- April 2011-

Medical Assistant Internship, Kaiser Permanente Hospital- 2001 EMPLOYMENT HISTORY

May 2018- Present

Reimbursement Technician, Desert Valley Medical Group

Directs the batching, posting and balancing of insurance and patient payments

Prepares and deposits work accounts in Nextgen

Maintains accurate batch spreadsheet records and reports for account specialists

Processes and distribute billing statements to attorney offices

Provides faultless customer and patient service

Possesses a remarkable understanding of health insurance contracts and medical codes August 2014- January 2017

Insurance Biller, Victor Valley Global Medical Center

Provides an empathic environment for patient care

Precisely reviews patient bills for accuracy and completeness

Processes billing rejections via correcting billing error and resubmitting claims to appropriate insurance carriers

Generates and submits patient claims to insurance companies for appropriate payment

Communicates with all hospital staff to ensure that the correct ICD9/ICD10, HCPCS, and CPT coding is reported on claims

Completes processing of unpaid claims within standard billing cycle timeframe 2

Identifies and bills secondary and tertiary insurance companies if applicable

Adheres to HIPAA guidelines to ensure patient confidentiality

Verifies patient insurance eligibility and responds to patient and insurance company

Expands knowledge base through attending educational opportunities

Knowledge and use of Medicare Managed Care, Medicaid Managed Care, and Commercial insurance guidelines

Completes necessary clerical tasks; scanning of documents, answering phones, processes mail for hospital and manages accounts receivable balance spreadsheet

Adhere to professional standards, hospital policies and procedures, federal, state, and local requirements

August 2005- March 2009

Office Assistant, John Burr Cycles

Executed monthly bank reconciliations and financial reports for managerial planning

Proofread and edited journal entries prior to publication to ensure accuracy

Complete purchase orders

Maintained financial bookkeeping

Managed a multiline phone system

Processed cash receipts and cash disbursements

Utilized basic office equipment

Managed accounts payable and receivable

June, 2004- August 2005

Cashier Sierra, 76

Responsible for sustaining daily business operations

Processed monetary transactions

Directed product placement

Created a customer friendly environment

January 2002- November 2003

Medical Assistant, Pyramid Biological

Greeted patients and managed reception area

Performed urinalysis and blood glucose testing

Prepared plasma bottles for patient use

Maintained patients’ files

Prepared and stocked exam rooms using sterilization methods

Utilized basic office equipment

REFERENCES UPON REQUEST



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