VERA ZEMETSKAYA
Elk Grove,CA
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
10
10
years of professional experience
Work History
Intake Rep 1
TriCare/Health Net Federal Services LLC
11.2016 - 01.2025
- Processed referrals and authorization requests for medical services per company guidelines and according to defined time and accuracy standards.
- Validated patients and medical providers demographic information including correct selection of provider by specialty for healthcare services.
- Reviewed and analyzed medical information, determining that medical treatments are consistent with patient’s diagnosis.
- Contacted medical provider offices by telephone.
- Enhanced customer satisfaction by efficiently processing intake forms and accurately entering data into the system.
- Served as a liaison between clients and healthcare providers, fostering strong relationships that facilitated seamless service coordination.
- Facilitated smooth transitions between different stages of care by effectively coordinating necessary steps during the intake process.
- Maintained strict confidentiality of client information, adhering to HIPAA regulations and company policies at all times.
Intake Rep 1
Kelly Services/HNFS
02.2016 - 11.2016
- Processed referrals and authorization requests per guidelines and according to defined time and accuracy standards
- Validated patient and medical provider demographic information including correct selection of provider by specialty for healthcare services
- Reviewed and analyzed medical information, determining that medical treatments are consistent with patient’s diagnosis
- Contacted medical provider offices by telephone
- Enhanced customer satisfaction by efficiently processing intake forms and accurately entering data into the system.
- Maintained strict confidentiality of client information, adhering to HIPAA regulations and company policies at all times.
Medical Insurance Billing and Coding Internship
Allmed Medical Center
12.2014 - 03.2015
- Entered daily charges for services and procedures in the medical billing system.
- Created CMS-1500 claims and submitted to third-party payers
- Printed medical records and insurance aging reports
- Sorted and organized files, spreadsheets, and reports.
- Gained hands-on experience in various software programs, increasing proficiency and expanding technical skill set.
Education
Associate of Arts - Medical Insurance Billing and Coding
Heald College
Rancho Cordova, CA04-2015
Skills
- Patient confidentiality
- Medical terminology
- Data entry proficiency
- Charting and clinical documentation
- Teamwork and collaboration
- Problem-solving
- HIPAA compliance
- Attention to detail
- Verbal and written communication
- Computer proficiency
Summaryofqualification
- Working knowledge of: CPT, HCPCS and ICD-10 codes; CMS-1500 and UB-04 claims processing; medical terminology; HMO, PPO, Medicare and Medicaid
- Excellent interpersonal and communication skills, hard worker, quick learner
- Ability to work in a fast-paced, intense environment smoothly
- Dependable work ethics with excellent attendance; strong attention to details
- Speak, read and write Belarussian, Russian, and English fluently
Languages
English
Full Professional
Russian
Native or Bilingual
Timeline
Intake Rep 1
TriCare/Health Net Federal Services LLC
11.2016 - 01.2025
Intake Rep 1
Kelly Services/HNFS
02.2016 - 11.2016
Medical Insurance Billing and Coding Internship
Allmed Medical Center
12.2014 - 03.2015
Associate of Arts - Medical Insurance Billing and Coding
Heald College
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