Contented Group Incorporated 

Healthcare Consultant

Northwest College

•Fostered and constructed lectures while displaying experienced nursing medical ethics and morals 
•Fostered and instructed CPR/AED courses 
•Assured students comply with the rules and regulations of the institution 
•Employed various teaching styles incorporating methods to accommodate diverse learning styles 
•Administered grade examinations to assess achievements of course as identified in the syllabus 
•Taught ICD 10-CM coding, CPT coding, HCPCS coding 
•Fostered and constructed lectures for medical terminology, and reimbursement strategies 
•Taught insurance regulations for filing CMS-1500, UB-04 insurance claims
• Taught and demonstrated Microsoft Excel, Word, PowerPoint

Medical Billing & Coding Instructor

Pharmaceutical Strategies 

•Responsible for working and triaging data entry-related Medicare Part D fax queues 
•Worked with SilverScript PDP, Health Plan Clients, Lexis Nexus, PeopleSafe, AS400, Excel, Outlook, Instant Messaging
•Reviewed faxed/electronic documents from physicians, pharmacists, nurses with accuracy while implementing nursing skills 
•Approved/ escalated to clinical for review/deny/redeterminations Medicare Part D medications 
•Coverage eligibility verification for MedicarePartD
•ICD 10-CM coding, NDC coding Medicare Part D drugs 
•Completed timely, and accurate documentation of Coverage Determinations/Appeal requests 
•Escalated issues to pharmacists or management as needed 
•Demonstrated sense of urgency with assignments 
•Identified and solved practical problems and dealt with a variety of concrete variables in standardized situations
•Performed medical nursing mathematical calculations for drugs
•Promoted to upskill for RFI queue to approve/deny/refer to pharmacist for Medicare Part D drug coverage

Medicare Coverage Determination & Appeals Technician Representative CVS (Contractor)

Air Methods

•Reviewed aged accounts, coordinate payments, and resolves remaining balances, review, resolve balances with insurance adjusters
•Indexed confidential documents to medical records 
•Communicated with attorneys, hospitals, patients, and insurance carriers 
•Submitted insurance claims to all insurance carriers for emergency ambulance services
•Reviewed financial data to determine possible Medi-Cal eligibility, verified with Passport and Connex 
•Verified and assured all accounts are ready for billing with adequate supporting documentation for supervisor approval 
•Processed patient payments electronically or offer charity assistance, accounts receivable/ billing and collections with Excel, Lexus Nexus, other medical payment processing websites
•Submitted CMS-1500 claims for Medicare, Medicaid, Medi-Cal, Worker's Compensation, Commercial, Private insurance carriers 
•Patient advocate while implementing nursing patient communication skills 
•Verified and processed patient insurances
•Processed patient payments, offered charity applications, and created payment arrangements 
•Reviewed/explained EOB's/ERA's with patients/members/insurance carrier representatives
•Processed patient payments electronically 
•Faxed invoices, determined possible eligibility for charity assistance per hospital charity policies

Patient Financial Counselor II

Brightwood College

•Taught ICD 10-CM coding, ICD 10-PCS, CPT coding, HCPCS coding for Medical Billing & Coding/Health Information Technician programs 
•Fostered and constructed lectures while displaying nursing medical ethics and morals 
•Taught and demonstrated reimbursement strategies
•Taught and demonstrated Medicare Appeals documentation, skip tracing, payment processing, transactions, and collections 
•Aided with the coordination of curriculum revision 
•Effectively used of the Learning Management System (LMS)/ Canvas 
•Fostered and constructed lectures for medical terminology, and reimbursement strategies 
•Taught and demonstrated filing CMS-1500, UB-04 insurance claims

Health Information Technician Instructor/Medical Billing & Coding Instructor 

Asher College

•Taught and prepared students for Certification in Microsoft Excel, Access, Word, Outlook, PowerPoint 
•Taught ICD10-CM coding, CPT coding, HCPCS coding 
•Fostered and constructed lectures while implementing nursing skills and work experience 
•Taught business administration, basic accounting, and medical office administration 
•Fostered and constructed lectures for medical terminology, and reimbursement strategies 
•Taught and implemented insurance regulations for filing CMS-1500, UB-04 insurance claims

Health Services & Business Programs Instructor

Anthem Education Group

•Promoted to foster staff of 10 or more and campus students to meet assured course content and objectives 
•Overseen a campus of 400+ students or more, adhering to all rules and regulations per company policies 
•Implemented employee evaluations, communicated/reviewed evaluations with Campus Director 
•Effectively displayed telephone communication skills with faculty, students, agents with federally funded programs 
•Daily communication with Campus Director to ensure student compliance, support throughout the college campus
•Monitored staff data, and assessed grade books of staff to ensure federal regulations were implemented for educational standards 
•Evaluated and completed postgraduates externship training course
•Taught within a classroom setting for all Medical Billing & Coding/Medical Front Office students AM and PM students
•Taught ICD9-CM, ICD9-PCS, ICD10-CM, ICD10-PCS, CPT, HCPCS coding

Team Lead/Program Director/Extern Coordinator/ Medical Billing & Coding Instructor 

Fastrax Corporation Learning Center

•Designed and administered grade examinations to assess achievements of course as identified in the syllabus
•Aided with the coordination of curriculum revision
•Adhered to all rules and regulations per company policies
•Redesigned all aspects of the program and provided efficient administrative support throughout the institution 
•Taught within a classroom setting for all Medical Billing & Coding/Medical Front Office students AM and PM students
•Taught ICD9-CM, ICD9-PCS, CPT, HCPCS, CDT coding
•Taught and demonstrated how to submit completed CMS-1500, HCFA-1500, CMS-1450, UB-04, ADA Dental Claim insurance forms

Program Director /Medical Billing & Coding Instructor

Consolidated Resorts

•Responsible for complying with all policies and procedures
•Resolved customer and member complaints
•Communicated with Sales Managers and Sales Representatives
•Monitored all collateral material for brand compliance
•Monitored selected outside vendors for presentation integrity
•Closely analyze each purchase for comfort level and full disclosure
•Closely monitored the activities of the sales floor, sales agents and managers
•Accountable for agent compliance when communicating with customers
•Directed clerical personnel to assist in contract preparation and owner communication

Complaince Agent/ Concierge

Chicago Title Insurance Company

•Administrative duties for executive management and staff
•Screened Calls
•Fostered calendars for meetings and trainings 
•Fostered travel arrangements for supervisor and staff
•Prepared meeting and event arrangements
•Prepared reports and financial data daily
•Trained and supervised other support staff
•Developed customer relations within the Real Estate office
•Worked with all levels of internal management and staff, as well as outside clients and vendors
•Displayed sensitivity to confidential matters
•Accurately calculated daily deposits for banking deposits

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