Eligibility Clerk Resume Example Alameda County Medical Center

ELIGIBILITY CLERK

Professional Summary

Motivated, adaptable professional with exceptional organizational, communication, and problem-resolution skills in the healthcare and customer service industry.

Skills

Extensive customer-service experience combined with excellent project-coordination and general administrative skills.
Computer proficiency including Microsoft Office Suite (Word, Excel, PowerPoint), Microsoft Outlook, Windows 2007), OAS GOLD, INVISION, ECW, Wellsoft,EZ-CAP.
Familiarity with Medi-cal, Medicare, FamPac and other government funded programs.

Knowledge of medical office and Emergency room procedures.
Bilingual in Spanish.

Work History

Eligibility Clerk , 06/2010 to Current
Alameda County Medical Center – Oakland, CA

Registered and interviewed patients to obtain accurate and complete demographic and financial information.
Managed various general office duties such as answering multiple telephone lines, completing insurance forms.
Researched and verified patient eligibility for insurance coverage.
Prepared and processed consent, charge slips, patient packets, and medical record forms.
Informed patients of the availability of government funded and charity discount programs.
Trained new employees on multiple medical billing programs and data entry software.
Verified and created claim numbers by communicating with various insurance companies.
Scheduled surgeries for multiple surgeons and booked operating rooms.
Trained new employees on multiple medical billing programs and data entry software.

Eligibility Worker , 09/2012 to 07/2013
San Francisco Department of Public Health – San Francisco, CA

Registered and interviewed patients to obtain accurate and complete demographic and financial information.
Managed various general office duties such as answering multiple telephone lines, completing insurance forms.
Researched and verified patient eligibility for insurance coverage.
Prepared and processed consent, charge slips, patient packets, and medical record forms.Informed patients of the availability of government funded and charity discount programs.
Located, checked in and pulled medical records for appointments and incomplete patient charts.
Contacted patients regarding unpaid and underpaid accounts to resolve any issues.
Trained new employees on multiple medical billing programs and data entry software.

Claims Examiner 1, 02/2009 to 09/2012
Community Health Center Network – San Leandro, CA

Responsible for processing/examining claims submitted by CHCN clinics based on comprehensive knowledge of benefits package based on utilization guidelines and appropriate division of financial responsibility.
Reviewed daily claims reports and adjust any errors.
Assisted in preparing audit packages for annual HMO audits and for certified coder review/PDR process including retrieving claims and other necessary documentation.
Worked with Certified Coder and/or Medical Director on claims requiring further examination for coding or medical review

Assistant Office Manager , 01/2005 to 02/2009
Altamira Construction Company – Oakland, CA

Ordered and distributed office supplies while adhering to a fixed office budget.
Oversaw inventory and office supply purchases.
Composed and drafted all outgoing correspondence and reports for managers.
Prepared and distributed payroll for staff of 12 direct reports.
Oversaw daily office operations for staff of 12 employees.
Compiled financial reports pertaining to cash receipts, expenditures and profit and loss.
Posted receipts to appropriate general ledger accounts.

Education

Bachelor of Science: Health Care Administration , Current
University Of Phoenix - Oakland, CA

Resume Overview

Companies Worked For:

Alameda County Medical Center
San Francisco Department of Public Health
Community Health Center Network
Altamira Construction Company

School Attended

University Of Phoenix

Job Titles Held:

Eligibility Clerk
Eligibility Worker
Claims Examiner 1
Assistant Office Manager

Degrees

Bachelor of Science : Health Care Administration , Current

Eligibility Clerk Resume Example

Resume Score: 80%

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