VIJAY LAKSHMI SHARMA

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

Elk Grove, CA 95758

916-***-****

adzkim@r.postjobfree.com

Qualifications:

. 15 years of experience working in a medical center handling patient and referral requests.

. Knowledge of claim processing in medical insurance segment comprising of ICD-9, ICD-10 and CTP coding

. In –depth knowledge of insurance policies and coverage’s, claim payment procedures

. Ability to work with numbers and word meticulously

. Familiarity about working in fast paced environment

. Strike a positive cooperative tone with both customers and coworkers

Professional experience:

LTC Consultanting Rocklin, CA August 2020/ November 2020

. Creating Census and balancing .

. Update patients profiles, especially if insurance has changed

. Post cash receipts from insurances.

. Bill all company insurances.

Blossom Ridge Home Health and Hospice Sacramento, CA January 2020/ March 2020

. Receptionist Duties: Answer phone calls, transfer phone calls, and greet individuals walking in.

. Verifying CPT Codes and ICD10 Codes

. Assisting managers with meetings from ordering meals, to having documents ready for the meeting.

. Insurance verification for eligibility, obtaining authorization for reimbursement for accounts for current patients.

Pacific West Pharmacy Rocklin, CA 10/05-April 2019

. Obtaining Authorizations

. Verifying CPT Codes and ICD10 Codes

. Admit patients to Nursing Homes when discharged from hospital.

. Insurance verification for eligibility, obtaining authorization for reimbursement for accounts, research diagnosis and insurance benefits to proper reimbursement and do all Medicare, HMO, Part D, TriCare, all government, VA, Per Diem billing online.

. Perform internal quality audits to ensure that all necessary documentation is included in each patient

Profile.

. Maintain professional communication with medical center staff, payers, physicians, and patients.

. Handle high volume of patient calls and complaints, payer’s correspondence, or in person contact.

. Do collection for 90 days past due, make sure all patient medication gets to the nursing facility at time of admission.

Core competencies:

. Strong written and verbal communication skill and goal oriented

. Organized and detail focused

. Adaptable to changes

. Team working oriented- Ability to prioritize and work minimum supervision. Bilingual

Technical Proficiencies:

. MS Word, Excel, Outlook

. MS PowerPoint

. MS Word Excel

. Citrix

Education:

Stanley High School

High School Dipolma

June 11,2020

GPA- 3.22

Anthem College, Sacramento

Billing and Coding Diploma

October 2004- July 2005

Awards: Academic Excellence and Perfect Attendance

Achievements:

. HIPPA & OSHA Complaint

. Attendance Award

PROFESSIONAL REFERENCE:

Peggy Knapp

Business Office Manager

Plum Health

2600 L Street

Sacramento, CA 95816

adzkim@r.postjobfree.com

916-***-****

Kady Kein

Blossom Ridge Home Health and Hospice

520 9th Street

Sacramento, Ca 95814

adzkim@r.postjobfree.com

530-***-****

Todd Harvey

Pharmacy Manager

Pacific West Pharmacy

4363 Pacific Street

Rocklin, CA 95677

adzkim@r.postjobfree.com

916-***-****

Contact this candidate