Cultural Autobiography Essay

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SKILLS/CERTIFICATIONS: WPM: 65; Meditrax Medical Software Certification in Coding – 10/2011, Knowledge of CPT and ICD-9 Medical Terminology, BLS/PALS/Fire & Safety Certification - American Heart Association 3M Infection Prevention Respiratory Protection Program Computer Software- Microsoft Word, Excel, PowerPoint, Outlook, Lawson, MEDITECH, HCA Atlas, Visual CACTUS/OFFICE ALLY/Secure IMS Link Certificate of Project Management Certificate of Completion – 360 training OSHA & the OSH Act PROFESSIONAL EXPERIENCE: LA CARE HEALTH PLAN, Los Angeles, CA Mar 2013-present PDR Specialist/Claims Department Processing of incoming PDR’s via certified mail, USPS, faxes, emails and all other sources of delivery methods. Sort through PDR receipts to identify and correctly route provider issues to the following departments, G&A, UM, Medical Management, claims production floor and the PDR unit. Utilize MHC to identify original claims being disputed by the Provider using the Provider dispute resolution process according to AB1455. Responsible for keying PDR’s into SSO system. Complete acknowledgement letters and mail out correspondence to providers. Receive calls that are forwarded from the member service department and claims provider call center regarding Provider dispute resolution inquiries. Follow-up with provider regarding requested information and waiver of liability request forms that are sent on Medicare members. Special projects as required WEST HILLS HOSPITAL & MEDICAL CENTER Jan. 2010 –July 2012 Occupational Health Assistant/Infectious Disease Coordinator • Establish and manage Occupational/Employee Health Program services and assist with developing in-house clinics • Provide administrative support to NP/Physicians Assistant as it pertains to corporate medical network Operations • Screens and prioritizes calls and
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