Objective: To obtain a position where I can use my professional experience
and skills.
Experience:
Claims Examiner Oct 2001 - Oct 2009 Santa Monica Bay Physicians, Culver City, CA
Responsible for adjudicating claims according to member health plan
benefits and DOFR payment responsibility matrix. Meeting daily
production standards, timeliness and compliance per guidelines.
Analyzed and reviewed claims to determine benefits
in accordance with plan policies, contacted provider participants
and insurance carriers. Generated appropriate letters or denials
based on established department guidelines. Proficient in medical
terminology, CPT, HCPCS and ICD-9 coding.
Data Entry/Payment Poster
Dec 1995 - Oct 2001 Santa Monica Bay Physicians, Santa Monica, CA
Responsible for updating patient insurance, demographic and account
information. Posted EOB’s from different payers, made any necessary
adjustments. Posted pre-coded charges and diagnosis from super bills. Daily
balancing of payments and co-payments for bank deposits. Assisted with month-end closing.
Tech. Publications Library Clerk
March 1991 - March 1995 Continental Airlines, Los Angeles, CA
Responsible for revising, distributing and maintaining various engineering
and maintenance documents....
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