Pamela S Giles
500 Ravine Road Birmingham, AL 35210
Contact Preference: 205-490-6269 email@example.com
Certified Medical Assistant
08/2011 – Present Virginia College - Estimated Graduation date 03/27/2014 See Skills List below
03/2008 – 07/2011
The Outsource Group
Customer Service Representative/Insurance Verification and Bill Collector
- Call to patients and insurance companies for the reason as to why bill not paid
- Calls to and mailed to attorneys on third party claims for automobile and workers compensation all documentation bills needed to be court approved, paid by the court
- Third party biller for Children’s Hospital
- Insurance verification
- Working knowledge of the ICD-9 and CPT codes for billing purposes
- Always attending meetings to stay on top of the latest insurance information that was breaking with Blue Cross /Blue Shield of Alabama
11/2004 – 01/2008
Alabama Orthopedic Spine & Sports Medicine Assoc. Birmingham, AL
- Patient Coordinator & Floater
- Worked front desk
- Entered all patient demographics
- Checked in patients
- Worked cashier desk for checking out patients and making return appointments.
- Patient transport to the lab, Birmingham Radiological Group & Same Day Surgery Admitting & to the
- Hospital Floors upon room assignment.
- Was working collections department, all front end duties during lunches, vacations and others sick leave.
12/2003 - 09/27/2004
Assurant Employee Benefits Birmingham, Alabama
Group Sales Assistant
- Receive all requests from brokers for employers seeking plans for voluntary life, voluntary dental & voluntary short and long term disability plans.
- Entered into solar system and assigned a number.
- Given to the appropriate salesman to determine what type of current coverage they have versus what they could be supplied with.
- Other duties: filing, answering phones, general office clerical activities, upkeep of files, making and maintaining all files.
- Working office equipment: Postage, FedEx, Copier, and Fax.
- Ordering all Office supplies and monitor usage thereof.
HRH Risk Services (Hilb, Rogal & Hobbs) Birmingham, Alabama
Workers’ Compensation Claims Adjuster
- Managed case load of approximately 150 Alabama Business Market Claims.
- Determined casual relationship/compensability; including evaluating medical records, taking
- recorded interviews, witness statements and accident investigation.
- Assigned Medical Case Managers, Attorneys, Physicians and other vendors for case handling.
- Responsible for resolution of claim whether there is return to work, settlement, mediation or
- Attended claims reviews with Business Market Clients to review case handling and case disposition.
- In adjudicating medical bills have worked with the HCFA 1500 forms and the UB92 forms,
- Worked with the CPT and ICD-9 codes in making determinations of compensability of medical
- charges incurred as a direct result of the on-the-job entry.
8/1994 - 10/1996
Winn Dixie – Cahaba Heights Birmingham, Alabama
Assistant Head Cashier
- All office operations to run the front end of the store, including customer relations.
- Made nightly deposit, picked-up from registers and maintained a computer of all entries for each
- cashier working under my shift.
- As assisted head cashier made out weekly work schedule.
- Transmitted grocery orders via computer & phone.
- Worked evening shift for approximately three months (11:00pm until 7:00am).
12/1991 - 1/1994
Baptist Medical Centers – Corporate Birmingham, Alabama
- Worked in the Comptrac Program, discounting BMC physician bills that were part of the Comptrac Program.
- Customer Service Representative, responsible for managing all employees’ medical treatment and payment of incurred bills.
04/1979 - 12/1991
Liberty Mutual Insurance Birmingham, Alabama
Workers’ Compensation Claims Adjustor
- Strategically planned, organized and managed multiple tasks and multiple employers and developed working relationships.
- Responsible for contacting the employers, employees and physician’s office for updates on current condition of return to work status.
- Skilled in employee relations and legal consultations as well. Vast communications with all parties involved (whether written or verbal).
- In adjudicating medical bills have worked with the HCFA 1500 form and the UB92 forms, as well as, worked with the CPT and ICD-9 codes in making determinations of compensability of medical charges incurred as a direct result of the on-the-job entry.
Skills List #2 Certified Medical Assistant (training) - actual learned skills
- Medical Law and Ethics
- Hand Washing
- Surgical Hand Washing
- Blood Glucose taken
- How to use PPD Equipment
- Taking Blood Pressure manually and by blood pressure machine
- EKG (placing leads on patient to have EKG done)
REFERENCES: Available upon request