Saleta Roseburr
Bakersfield,CA
Summary
Disciplined individual provides administrative and clerical support to medical staff. Proven record of accurately organizing, filing and retrieving patient information. Experienced in coding medical records and entering data into patient databases.
Overview
14
14
years of professional experience
Work History
Medical Records Clerk/ Qualcare Medical Researcher
Central Cardiology
Bakersfield, CA
11.2018 - 12.2020
- Maintained confidentiality of all medical records and sensitive information to comply with HIPAA regulations.
- Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
- Utilized electronic medical record systems to store, retrieve and process patient data.
- Obtained client medical history, medication information, symptoms, and allergies.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Verified signatures and checked medical charts for accuracy and completion.
Records Clerk
Klein DeNatale Goldner Attorney’s At
Bakersfield, CA
06.2015 - 11.2018
- Responsible for following a filing system and organizing records, such as letters, legal documents, case files, correspondence, invoices and memoranda
- Locate and retrieve requested files, as well as prepare legal document indices, file folders and labels
- Responsible for keeping files up-to-date.
- Assisted with typing, data entry, and answering incoming calls as required.
- Followed confidentially regulations to maintain privacy.
Front Office Coordinator
Terrio Physical Therapy & Fitness
Bakersfield, CA
07.2010 - 12.2014
- Consulted with physical therapist, doctors, intake, billing and other office coordinators
- Verification of insurances, adhere to HIPAA regulations
- Daily patient interaction 60 plus patients
- Helped walk-ins by collecting all pertinent information
- Checked patients in and out ensuring that correct authorization is attached to each encounter
- Collected and recorded patient co-pays, deductibles, co-insurance, and no-show fees; handled cash, checks and credit cards
- Recorded and maintained number of times patients were seen by therapists
- Canceled appointments, rescheduled patients
- Planed and implemented records, forms, and process for successful and efficient flow of data in system
- Created and replied to emails constantly
- Answered phones as necessary, transfer calls to correct department
- Printed, faxed and copied documents
- Made confirmation calls daily
- Retrieved charts for next business day appointments
- Calculation of patient balance sheet
- Close out currency transactions each day.
UM Non-clinical Intake Coordinator
Kern Health Systems
Bakersfield, CA
06.2024 - Current
- Screen calls from KHS providers and KHS members regarding the KHS UM process.
- Obtain referral information from providers and members to implement and facilitate the authorization process.
- Act as liaison to KHS members, community providers, and employees to the UM clinical staff.
- Assigns diagnostic and procedural codes using ICD10, and CPT coding classification system for service requests. Requests input from the Clinical Intake Staff when needing direction or clinical expertise.
- Reviews specified referral types using established criteria for purposes of pre-authorization of payment; when indicated routes requests to Clinical Intake Coordinators for approval or auto-authorizations.
- Benefits interpretation to include coordination of care for medically necessary services that are not covered under the KHS Plan (e.g. CCS, Long Term Care, and State Waiver Programs.)
- Obtains additional medical information for clinical staff for preparation of authorizations for Clinical Intake Coordinator review.
- Coordination of Health Plan services between KHS UM Department and KHS Member Services and Provider Relations.
- Reviews member history and eligibility and previous referral authorizations.
- Monitors, tracks, and processes provider service appeals.
- Ensures accurate data entry of authorizations in the QNXT system.
- Acts as a resource to Non-Clinical Intake Coordinator Level I and Non Clinical Intake Coordinator Level II staff.
- Adheres to KHS’s Code of Ethics and Business Conduct and all company policies; e.g., confidentiality, attendance, safety/security, use of equipment and technology, appearance and demeanor.
Education
Bachelor of Science - Healthcare Administration
University of Phoenix
01.2024
Medical Assistant Certificate - undefined
Maric College
2007
Diploma - undefined
Bakersfield High School
2005
Skills
- Front and back office coordination
- MS Office Suite
- Planning and Scheduling
- Medical Terminology
- Telephone Reception
- Knowledge of referral scripts, authorizations, and health insurance
- E-Clinical (ECW)
Timeline
UM Non-clinical Intake Coordinator
Kern Health Systems
06.2024 - Current
Medical Records Clerk/ Qualcare Medical Researcher
Central Cardiology
11.2018 - 12.2020
Records Clerk
Klein DeNatale Goldner Attorney’s At
06.2015 - 11.2018
Front Office Coordinator
Terrio Physical Therapy & Fitness
07.2010 - 12.2014
Medical Assistant Certificate - undefined
Maric College
Diploma - undefined
Bakersfield High School
Bachelor of Science - Healthcare Administration
University of Phoenix