Medical Assistant
Resume:
Cynthia Rutherford
Ripley, WV 252 71
Objective: Self-motivated individual with numerous years’ experience in the Healthcare Industry, Insurance Claims Adjuster, public relations, collections and Medical Assistant. Currently hold a WV claims adjuster license. I am seeking employment with a company that has room for growth.
Sedgwick CMS
300 Capitol Street
Charleston, WV 25301
Claims Adjuster II
6/2011-4/2012
Responsibilities: Plan the overall medical and indemnity management associated with compensable injuries. Establish proper protocol and project the need and possible complications with severity of claim. Consult with internal and external medical, legal and vocational professionals on current treatment, litigation or rehabilitation plans to ensure outcome levels are achievable and appropriate. Analyze medical, legal and vocational reports against established guidelines. Investigate and evaluate claims for settlement. Work closely with Attorney General’s office with litigation files. Act on Office of Administrative Law Judge Orders. Set reserves in the claim for life expectancy. Work independently at home on scheduled days. Answer emails, phone calls and customer inquiries. Perform all other duties from my home based computer.
WV Department of Environmental Protection-Office Assistant III
601 57th Street
Charleston, WV 25304
4/16/09-6/2010
Responsibilities: Act as administration support to the permitting department. Enter and close all permits in ERIS. Answer all incoming calls and correspondence from all parties involved. Prepare and scan documents. Mail permits certified. Enter checks into ERIS. Work closely with engineers to ensure timely processing of permits. Answer phones and file.
Jackson Medical Associate-Medical Biller
PO Box 171
Ripley, WV 25271
10/2005-05/2007
Responsibilities: Billed all charges using CPT and ICD9 Coding. Phoned insurance companies for verification of coverage. Routed calls to the necessary person and take messages. Acted upon what is deemed an emergency. Post all payments and run a daily ledger. File WC123's and verify correct diagnosis codes. Phone insurance companies to follow up on payment on bills. Set up payment plans for patients with hardship. Call insurance companies for authorizations and process referral forms. Prepare prescriptions for the doctor’s signature. Assist with triage of patients. Schedule diagnostic testing and referrals. Assist patients with test results. Typed letters from dictation.
Bureau of Employment Programs-Deputy Claims Manager
4700 MacCorkle Avenue
Charleston, WV 25305
Supervisor: Lelani Vanmeter
5/2000-10/2005
Responsibilities: Approved or denied diagnosis codes in correspondence with claims. Verify that procedure code used was in relation to the injury. Requested treatment plans from physicians and other providers. Reviewed and acted upon Administrative Law Judge orders. Assist attorneys with litigation claims. Work independently without supervision. Authorized medications and treatment plans. Review physical medical forms to ensure guides were being followed.
Education:
8/91-12/91 West Virginia University
Ripley, WV 25271
Computer Science
1/92-5/93 WV State
Dunbar, WV 26064 Computer Science
Certifications: WV Insurance Adjusters License
References: Becky Bower 304-***-****
Martha Watson 304-***-****
Jessica Casto 304-***-****
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