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Rosa N. Burgos
120 Ledgewood Drive
East Stroudsburg, PA 18301
570-688-7178
rosanburgos@gmail.com
EDUCATION
Berkeley College, Dover, NJ 9/2012-3/2014
Diploma: Multi-Level Patient Care Technician
Dean’s List
Excellent Attendance
Fordham University 8/1985-12/1987
Liberal Arts
COURSE OF STUDY
• Fundamentals of Patient Care
• Medical Law and Ethics
• Anatomy and Physiology
• Medical Terminology
• Patient Care Procedures
• Introduction to Clinical
• Electrocardiography (EKG)
• Phlebotomy/ Hematology
• Advanced Patient Care Techniques and Clinical
• Long Term Care Techniques and Clinical
• Home Health Care Techniques and Clinical
• Medication Procedures Techniques and Clinical
Clinical Rotation
Mi Casa Es Su Casa, Paterson, NJ Nov 13 – Dec 20, 2013
Chilton Hospital, Pompton Plains, NJ Feb 21 – March 26, 2014
Patient Care Technician
Hands on experience with the following:
• Vital signs on all assigned patients
• Glucose testing
• Wound care
• Transported patients for therapy
• Patient Hygiene/ADLs
• EKG
• Documentation/charting of care given
Certifications:
Patient Care Technician/Patient Care Associate/Nurse Technician 3/2016
CPR 8/2015
EKG 3/2015
Phlebotomy 6/2016
EXPERENCE
ExamOne Allentown, PA 18104
Paramedical Examiner 5/2014 to 1/2015
• Independent contracted examiner completing mobile phlebotomy and
insurance exams.
• Complete insurance exams, draw blood, collect urine specimen, take
physical measurements.
• Prepare patient collection for processing; pack and ship specimens and
insurance forms to corresponding lab.
Sedgwick CMS (formerly CISGI / Xchanging) – Whippany, NJ 07983 2/07-Present
Claim Examiner (1/2015 to Present)
Claim Representative (10/2012 to 1/2015)
• Investigate, evaluate, and settle workers compensation claims.
• Take recorded statements and other duties as assigned.
• File appropriate state forms in timely manner.
• Contact with medical providers, nurse case managers, attorneys.
• Implement appropriate procedures to minimize client’s exposure.
• Prepare claims for settlement and negotiate settlement with best outcome.
• Appropriate review of reserves and settlements.
• Pursue settlements to resolve claims full and final.
Medical Only Claims Adjuster (10/09 to 9/2012)
• Investigated, evaluated, and processed Medical Only Worker’s Comp
claims.
• Thorough investigation of claims to determine compensability.
• Evaluated losses as it pertains to coverage.
• Timely medical bill and records review.
• Entered claims diaries, memos, reserves, and request background checks.
• Kept current with all applicable laws and regulations.
• Timely response to emails, phone calls, projects.
• Other administrative and clerical duties.
Customer Service Rep (2/07 to 10/09)
• Handled incoming calls.
• Obtained loss reports for insured.
• Created worker’s compensation, auto and general liability claims
manually.
• Directed new input of records into system.
• Set up computer files and hard files on new losses.
• Inputted all bills associated with file for payment and requested special
funding if necessary.
• Managed misc financial transactions.
• Completed accurate and timely malpractice payment for various state
boards.
• Updated and maintained computer input on claims; entered claim diaries,
memos, reserves, and request background checks, added bodily injuries and property
damage lines to existing claims.
• Compiled data and produced reports on specific programs as necessary.
• Assisted risk consultants with attach to file and maintenance of claim files
including upgrading status and closures.
• Processed incoming and outgoing mail, photocopied, scanned, and faxed
documents, maintained open files shelving and off-site storage files.
Michael A. Hunt Family Dentistry – Marshalls Creek, PA 18335 2/02 to 1/07
Office Manager
• Managed and implemented a diversity of administrative and supportive
functions.
• Supervised 3 office employees.
• Heavy interfacing with insurance companies for correct preparation of
claims to ensure prompt claim payments.
• Working knowledge of appeals and claim denials.
• Inputted and updated patient financial accounts including Medical
Assistance and Major Dental Insurance transactions and Accounts Receivable/Payable.
• Advised patients of insurance coverage and benefits and offered alternate
financial options.
• Processed notices and collection letters to patients.
• Maintained Excel spreadsheets for tracking collection activities.
• Generated statistical reports, EOD/EOM/EOY financial reports, backed up
files, generated daily deposit slips and money logs.
• Scheduled dentist / hygienist for seminars and Continuing Education
credits and coordinated travel.
• Responsible for miscellaneous office operations.
Joyner's Sports Medicine – East Stroudsburg, Pa 2/01 to 2/02
Receptionist
• Maintained patient scheduling.
• Heavy interfacing with insurance companies for correct preparation of claims to
ensure prompt claim payments.
• Inputted and updated patient financial accounts.
Pocono Pediatrics 12/00 to 1/02
Receptionist
• Maintained patient scheduling.
• Heavy interfacing with insurance companies for correct preparation of claims to
ensure prompt claim payments.
• Inputted and updated patient financial accounts.
• Welcomed and announced medical vendors.
• Maintained doctor’s ER schedule.
New York University College of Dentistry – New York, NY 10010 9/89 – 11/00
Senior Clinical Aide / Pediatric Department (8/95 – 11/00)
• Managed and implemented a diversity of administration and support
functions.
• Served as liaison for various outreach programs, including Medicaid and
Child Welfare Agencies.
• Operated personal computer equipment utilizing various databases
inputting and updating patient financial accounts including Medicaid, and HMO
insurance transactions, Accounts Receivable / Payable.
• Responsible for miscellaneous office operations including typing, faxing
and scanning.
Senior Cashier / Clerk – Pediatric Department (9/89 – 7/95)
• Utilized customer service skills to greet and register patients.
• Served as clinic cashier.
• Answered multiples phones lines.
• Scheduled and maintained patient appointments.
• Responsible for miscellaneous office operations.
SKILLS:
Certified Phlebotomist, Certified EKG Tech, NY Independent Adjuster License, fluent in
Spanish, Transcription, Member of NJ WC Association.

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Resume 6 2014

  • 1. Rosa N. Burgos 120 Ledgewood Drive East Stroudsburg, PA 18301 570-688-7178 rosanburgos@gmail.com EDUCATION Berkeley College, Dover, NJ 9/2012-3/2014 Diploma: Multi-Level Patient Care Technician Dean’s List Excellent Attendance Fordham University 8/1985-12/1987 Liberal Arts COURSE OF STUDY • Fundamentals of Patient Care • Medical Law and Ethics • Anatomy and Physiology • Medical Terminology • Patient Care Procedures • Introduction to Clinical • Electrocardiography (EKG) • Phlebotomy/ Hematology • Advanced Patient Care Techniques and Clinical • Long Term Care Techniques and Clinical • Home Health Care Techniques and Clinical • Medication Procedures Techniques and Clinical Clinical Rotation
  • 2. Mi Casa Es Su Casa, Paterson, NJ Nov 13 – Dec 20, 2013 Chilton Hospital, Pompton Plains, NJ Feb 21 – March 26, 2014 Patient Care Technician Hands on experience with the following: • Vital signs on all assigned patients • Glucose testing • Wound care • Transported patients for therapy • Patient Hygiene/ADLs • EKG • Documentation/charting of care given Certifications: Patient Care Technician/Patient Care Associate/Nurse Technician 3/2016 CPR 8/2015 EKG 3/2015 Phlebotomy 6/2016 EXPERENCE ExamOne Allentown, PA 18104 Paramedical Examiner 5/2014 to 1/2015 • Independent contracted examiner completing mobile phlebotomy and insurance exams. • Complete insurance exams, draw blood, collect urine specimen, take physical measurements. • Prepare patient collection for processing; pack and ship specimens and insurance forms to corresponding lab. Sedgwick CMS (formerly CISGI / Xchanging) – Whippany, NJ 07983 2/07-Present Claim Examiner (1/2015 to Present) Claim Representative (10/2012 to 1/2015) • Investigate, evaluate, and settle workers compensation claims. • Take recorded statements and other duties as assigned.
  • 3. • File appropriate state forms in timely manner. • Contact with medical providers, nurse case managers, attorneys. • Implement appropriate procedures to minimize client’s exposure. • Prepare claims for settlement and negotiate settlement with best outcome. • Appropriate review of reserves and settlements. • Pursue settlements to resolve claims full and final. Medical Only Claims Adjuster (10/09 to 9/2012) • Investigated, evaluated, and processed Medical Only Worker’s Comp claims. • Thorough investigation of claims to determine compensability. • Evaluated losses as it pertains to coverage. • Timely medical bill and records review. • Entered claims diaries, memos, reserves, and request background checks. • Kept current with all applicable laws and regulations. • Timely response to emails, phone calls, projects. • Other administrative and clerical duties. Customer Service Rep (2/07 to 10/09) • Handled incoming calls. • Obtained loss reports for insured. • Created worker’s compensation, auto and general liability claims manually. • Directed new input of records into system. • Set up computer files and hard files on new losses. • Inputted all bills associated with file for payment and requested special funding if necessary. • Managed misc financial transactions. • Completed accurate and timely malpractice payment for various state boards. • Updated and maintained computer input on claims; entered claim diaries, memos, reserves, and request background checks, added bodily injuries and property damage lines to existing claims. • Compiled data and produced reports on specific programs as necessary. • Assisted risk consultants with attach to file and maintenance of claim files including upgrading status and closures.
  • 4. • Processed incoming and outgoing mail, photocopied, scanned, and faxed documents, maintained open files shelving and off-site storage files. Michael A. Hunt Family Dentistry – Marshalls Creek, PA 18335 2/02 to 1/07 Office Manager • Managed and implemented a diversity of administrative and supportive functions. • Supervised 3 office employees. • Heavy interfacing with insurance companies for correct preparation of claims to ensure prompt claim payments. • Working knowledge of appeals and claim denials. • Inputted and updated patient financial accounts including Medical Assistance and Major Dental Insurance transactions and Accounts Receivable/Payable. • Advised patients of insurance coverage and benefits and offered alternate financial options. • Processed notices and collection letters to patients. • Maintained Excel spreadsheets for tracking collection activities. • Generated statistical reports, EOD/EOM/EOY financial reports, backed up files, generated daily deposit slips and money logs. • Scheduled dentist / hygienist for seminars and Continuing Education credits and coordinated travel. • Responsible for miscellaneous office operations. Joyner's Sports Medicine – East Stroudsburg, Pa 2/01 to 2/02 Receptionist • Maintained patient scheduling. • Heavy interfacing with insurance companies for correct preparation of claims to ensure prompt claim payments. • Inputted and updated patient financial accounts. Pocono Pediatrics 12/00 to 1/02 Receptionist
  • 5. • Maintained patient scheduling. • Heavy interfacing with insurance companies for correct preparation of claims to ensure prompt claim payments. • Inputted and updated patient financial accounts. • Welcomed and announced medical vendors. • Maintained doctor’s ER schedule. New York University College of Dentistry – New York, NY 10010 9/89 – 11/00 Senior Clinical Aide / Pediatric Department (8/95 – 11/00) • Managed and implemented a diversity of administration and support functions. • Served as liaison for various outreach programs, including Medicaid and Child Welfare Agencies. • Operated personal computer equipment utilizing various databases inputting and updating patient financial accounts including Medicaid, and HMO insurance transactions, Accounts Receivable / Payable. • Responsible for miscellaneous office operations including typing, faxing and scanning. Senior Cashier / Clerk – Pediatric Department (9/89 – 7/95) • Utilized customer service skills to greet and register patients. • Served as clinic cashier. • Answered multiples phones lines. • Scheduled and maintained patient appointments. • Responsible for miscellaneous office operations. SKILLS: Certified Phlebotomist, Certified EKG Tech, NY Independent Adjuster License, fluent in Spanish, Transcription, Member of NJ WC Association.