Customer Service Medical

Anaberta Sanchez

**** ***** ***** ** 702-***-****

Las Vegas NV, 89108

********@*****.***

Objective

To obtain position in the healthcare industry in a well established company were I will be able to utilize my work knowledge and work experience. To be able to move up in the company and work in a professional and friendly environment.

Skills

ten key by touch, 30wpm, excellent customer service skills, familiar with ICD-9 and CPT codes and HMO plans, EOB, payment posting ,heavy phones and multiple phone lines, knowledge with ,faxing, medical records ,e-mails, scheduling appointments, Excel, EZ-cap, Galen, Multi task person, outgoing and always looking for a challenge. Multi-task

Professional Experience

Pennylane Centers (08/2010 - 07/2010) 661-***-****

Eligibility Worker - Lancaster, CA

Verify eligibility and prior authorization for clients. Bill insurance companies and medical for services provided by Pennylane. Post payment from EOB's received from insurance.

PoActive Health Services (02/2010 - 08/2010) 661- 945-5999

Front office/Authorization Coordinator - Lancaster, CA

Work in a fast pace environment in a occupational medicine office knowledge of front office and heavy phones, in charge of greeting and registering patient in and checking them out in a timely manner, helping patient with paper work. Responsible for making sure patients are scheduled for their next visit, making sure all charts have correct documentation and are ready for the doctor to have when patient is seen. Assist with back office when needed, process all referral and authorization that are needed for patients.

High Desert Medical Group (01/2003 - 06/2009 ) 661-***-****

Medical claims processor – Lancaster, CA

Process Medical and HMO claims in full accordance with the current and relevant provision of applicable plan documents. Responsible for accurate and timely adjudication of each claim accurately entering the claim into the processing system. Investigate and verify eligibility and prior authorization for claimant. Monitor and follow up on pending claims on a timely manner. Determine extent of patient’s medical group responsibility. Make approvals or denial decisions and negotiate with health plans to settle payment, processed in patient and out patient claims.

Education

Polytechnic High School Sun Valley, CA (09/1993-06/1995)

Degree Earned: High School Diploma

Bryman College (05/1997-05/1998)

Other Degree Earned: certificate

Major/Concentration: Medical Assistant

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