Sara Vang
Fresno,CA
Summary
Highly motivated and committed Medical Assistant with proven history of superior performance at individual, team and organizational levels. Multitasks and prioritizes workloads with little or no supervision. Detail-oriented professional looking to bring medical background and team-building skills to deadline-driven environment.
Overview
11
11
years of professional experience
Work History
Industrial Billing Reporter
The Permanente Medical Group (TPMG)
08.2022 - 12.2023
- For all medical services related to treatment of industrial injuries or illnesses: Create and maintain complete industrial claim files using internal systems
- Obtain, validate and update all necessary patient, employer and carrier information needed to create, complete and/or maintain industrial medical reports as required by law using internal applications or systems
- Using daily registration reports, internal systems or other means, track necessity of industrial documentation and create reports linked to industrial claim file
- From physicians' notes, abstract information necessary to prepare industrial medical reports
- Enter data into the internal applications and systems
- Ensure appropriate diagnostic codes
- Obtain necessary signatures from providers as appropriate
- Perform quality assurance control by linking registrations and documentation to correct industrial claims file
- Ensure follow up treatment is scheduled in accordance with the treatment plan
- Transmit required information, reports and forms to appropriate insurance claims administrator in a timely manner and within program service standards and/or applicable state or federal law
- Prepare other related industrial injury forms as required by applicable state or federal law.
Claims Specialist Payment Integrity
HealthComp LLC.
08.2022 - 02.2023
- Utilize problem solving skills and attention to detail to ensure that clients and their members minimalism of loss with higher revenue recoveries
- Collect, track, update, and model financial data to analyze information to find root causes
- Prioritized and organized tasks to efficiently accomplish service goals
- Utilized Visium pricing for Medicare like rates for staff support to negotiate repayment plans for providers and patients
- (Including Workers compensation, ambulance, Out-of-Network, PPO, HMO, etc.)
- Processed and self-audited out of network medical claims for Anthem Blue Cross and Blue shield plans
- Administrative support for subrogation team and Fee Negotiation team
- Process all medical claims and adjust medical disputed claims (Professional and Facility) according to department, contract, and regulatory requirements
- Troubleshoots claims that have been identified as needing additional work in the areas of eligibility, referral authorization and contracting or provider set-up
- Process all types of medical claims and adjust medical disputed claims (Professional and Facility) according to department, contract, and regulatory requirements
- Troubleshoots claims that have been identified as needing additional work in the areas of eligibility, referral authorization and contracting or provider set-up
- Escalated files with significant indemnity exposure to supervisor for further investigation
- Conducted full claim investigations and reported updates and legal actions.
Account Clerk I/ Medical Biller
Department of Behavioral Health Fresno County-Fresno, CA
02.2022 - 08.2022
- Maintains departmental appropriation, expenditure and revenue records including monitoring budget units, contracts, and accounts, checking records for arithmetic errors and completeness of budget codes, and preparing forms to transfer funds
- Post financial transactions, including distributing costs of payments to various accounts, posting to accounts, journals, and ledgers; and adjusting accounts
- Reviews accounts for proper payments, charges, and statements; adjusts accounts and resolves discrepancies between payments, receipts, or accounts
- Audits charges including checking and verifying codes and fees for conformity to laws, rules, and/or regulations
- Prepares and assists in preparing financial reports, statements, and periodic reports on condition of appropriation, accrual receipts, contracts, demands payable and accounts receivable.
Funding Specialist
Valley Children's Hospital-Madera, CA
08.2015 - 08.2021
- Secure funding for all outpatient services including ambulatory practices, day surgery, and imaging services
- Effectively manages authorizations for scheduled and retro services for outpatient and ancillary locations
- Ensure eligibility is verified prior to date of service including secondary payers
- Screen for CCS eligibility, screens for urgent authorizations, screens for authorizations prior to scheduled procedures and follow up appointments
- Input all patient data regarding claims and prior authorizations into the system accurately
- Verified eligibility and compliance with authorization requirements for service providers
- Tracked referral submission during facilitation of prior authorization issuance
- Reviewed appeals for prior authorization requests and communicated with payers to resolve issues
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines
- Obtained and logged accurate patient insurance and demographic information for use by insurance providers and medical personnel.
Medical Coordinator/ Transcriber
Emerzian Chiropractic - Fresno, CA
01.2013 - 08.2015
- Create Doctor First Reports, Progress Reports, Stationary and Permanent Status reports via dictation
- Liaison between employees, employers and payors to coordinate appointments, referrals authorization and communication regarding work restrictions, extended time off, need for further treatment and vocational rehabilitation
- Makes provisions for offsite work process and job duty evaluations; makes recommendations to employers and employees with concerns regarding work-place hazards
- Provide continuity of care to patient by coordinating needed services and consultation, such as physical therapy, orthopedic surgery, etc
- Monitors patients progress at work and triggers review for work modifications
- Meets with employer/employee groups and workers compensation carriers to review, evaluate and discuss specific problems and concerns per case management guidelines
- Maintain 98% accurate terminology and capture rate on data entry
- Produce 95% of physician reports in a timely manner
- Collects data and prepares reports
- Assists in the development and presentation of educational programs for work-site health promotions
- Works with business office staff to assist in organization of authorization for care and efficient billing and other paperwork required by employers and insurance carriers
- Recorded information using word processing, dictation and transcription software and equipment
- Followed all HIPAA rules and regulations regarding patient confidentiality
- Worked cohesively with physicians, employers, payors, patients and other clinical staff to assure organized and efficient management of medical care to return work-injured patients back to work.
Education
Bachelors of Science Degree - Health Information Management -
Western Governors University
Salt Lake City, UTAssociate in Science Degree - Medical Billing & Coding -
Ultimate Medical Academy
Tampa, FLCertification of Medical Assistant -
Sanger Adult School
Sanger, CA06.2024
Skills
- HIPAA Compliance
- Patient Scheduling
- Medical terminology knowledge
- Vital signs monitoring
- EMR / EHR
- Clinical Documentation
- Immunization Administration
- Appointment Setting
- Patient Flow Management
- First Aid
- Anatomy and Physiology Knowledge
- Fluent in Hmong
Medical Qualifications
- CMA
- CPR/ BLS
- Anatomy & Physiology
- Government Payers
- Medicare & Medicaid
- TRICARE
- Elec. Medical Records
- Third-Party Payers
- Worker's Compensation
- Managed Care (HMO, PPO, and POS)
- Office Management
- Typing/Filing Documents
- Co-Payments and Deductibles
- Scheduling Appointments
- Answering Phones
- ICD-9-CM/ ICD-10-CM, HCPCS, CPT
- Medical Terminology
- HIPAA
- UB-04
- HCFA
- Insurance Claim Processing
- EOB
- Insurance Billing Procedures
- Data Entry
Languages
Hmong
Native or Bilingual
Certification
- CMA - Certified Medical Assistant
- RMA - Registered Medical Assistant
- First Aid/CPR Certified
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Industrial Billing Reporter
The Permanente Medical Group (TPMG)
08.2022 - 12.2023
Claims Specialist Payment Integrity
HealthComp LLC.
08.2022 - 02.2023
Account Clerk I/ Medical Biller
Department of Behavioral Health Fresno County-Fresno, CA
02.2022 - 08.2022
Funding Specialist
Valley Children's Hospital-Madera, CA
08.2015 - 08.2021
Medical Coordinator/ Transcriber
Emerzian Chiropractic - Fresno, CA
01.2013 - 08.2015
Bachelors of Science Degree - Health Information Management -
Western Governors University
Associate in Science Degree - Medical Billing & Coding -
Ultimate Medical Academy
Certification of Medical Assistant -
Sanger Adult School
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