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Summary

Proficient Administrative Written Communication, Astute Research & Information  Collection Skills, Organization, Analyzing Information , Professionalism, Problem Solving, Verbal & Written Communication, Listening, Customer Focus, Handles Pressure, Data Entry Skills, Word Processing , Thoroughness, Attention to Detail, Decision Making, Informing Others, Results Oriented

Work experience

January 2018August 2018

Reimbursement Specialist

SyMed Corporation

* Imported charges from various clients by accessing multiple EHI/EHR platforms, pulled data, uploaded to internal billing software.

* Responsible for daily billing operation of thousands uploaded to MediCal. 

* Entered admission, changes, and discharge population data for multi-site mental health contract enabling billed procedures and codes to correspond accurately.

* Ran various reports to manage A/R by following up on claim denials from MediCal and private insurances (Blue Cross, Blue Shield, Aetna, Optum/UHC, Cigna, Kaiser etc.) 

* Proactively returned responses to denials to ensure time frame limits were not exceeded.

Aug 2014January 2018

Optometrist Assistant / Office Management

Dr. Lynell Heatley, OD - American Canyon Optometry (FirstSight Vision)
  • Administer optical pre-tests to patients: Auto-Refraction, Visual Fields (Oculus), NCT , Color Vision
  • Calendar set-up, maintenance - update scheduling appointments or accept walk-ins if availability exists
  • Distribute patient intake forms, privacy practices - compliance of HIPPA acknowledgment etc.
  • Adhere to confidentiality requirements of secure records/data
  • Retrieval & respond to prescription verification requests;  Department of VA referral documentation
  • Insurance: confirm eligibility status of patient for services, determine applicable reimbursements, co-payment & out-of-pocket amounts
  • Entry of correct ICD-10 diagnoses codes per procedure CPT code
  • Completion of HCFA Claim form -ready for Provider signature; Then Claim Submission via electronic clearinghouse (Availity), online portals (VSP 20/20, Davis, Spectera), or Fax/mail-in 
  • Acquisition of patient benefit coverage through various In-Network & Out-of -Network Insurances accepted by Provider; Follow up on payment of claim reimbursement 
Jul 2014Jul 2014

Wine Club Assistance - Temp Assignment

Pine Ridge Vineyards
  • Expedited focus of project to provide main point of contact across multi-level clubs (tiered membership) in coordinating updates for declined credit cards on file
  • Recovered delinquent accounts through implementing call-for-action email template design to create a sense of urgency which directed attention & motivated response
May 2013Feb 2014

Wine Club Assistant / Hospitality Representative

Bouchaine Vineyards
  • Processed multiple club shipments with various additions, promos, exceptions into data system for fulfillment &/or manual import of orders into shipment software to package in-house (*depending on State criteria /permit requirements).
  •  Ran reports to identify pending payments, expired accounts, incomplete/incorrect info
  • Investigated issues using multiple resources: direct contact, correspondence, data files, records, transaction history etc & offered solutions in resolve of standard/complex issues. Pursued completion through team collaboration & ensured resolution through dedicated follow-up.
  •  Input & organization of membership information – incl. setup, update & cancellation of confidential billing accounts.
  • Tasting Room open-close procedures, stocking & inventory counts of wines for club shipments, orders & library. Enticed visitors with winery “story”, shared benefits & special discount pricing of inclusive membership options, driven to provide top service & create an enjoyable experience within a fast paced atmosphere 
  • Provided all visitors with gracious service, optimized club member signups through custom pourings – Used judgement to modify “menu” complimenting preferences. Assisted in all aspects in special/ VIP events.
Jan 2006Aug 2011

Receptionist/ Cashier Expeditor/ Sales Associate

Golden Gate Roofing Co./ C-Casa/ Pac-Sun & Quiksilver Factory Outlets

Technical Competencies

drChrono EHR    Doc-me-in   SimpleTrack

E-bridge    Groupwise   Solution Reach

AMS   Vin65 / eWinery 

ShipCompliant   UPS WorldShip

FedEx Shipment Manager   N.V. POS

MS Office Suite 2003/2007 +

Accurate Database Entry   Spreadsheets

Word processors   Email: Account Setup

Internet Explorer / Firefox / Chrome

Micros - POS Cash Register

Education

20002004

H.S. Diploma

Napa Valley Alternative School

Certifications

Sep 2009Present

Certificate of Completion - Technology 101: A Small Business Guide

U.S. Small Business Administration- Office of Entrepreneurial Development

Professional Affiliations/ Community Activities

Napa Historical Society

The Goodman Library 

1219 First Street 

Napa, CA 94558 

Research Staff - (Volunteer)

Napa County Animal Shelter 

942 Hartle Court

Napa CA, 94558

Kennel Tech - (Volunteer)