1. AMADO F GONZALES
4223 S. 600 W
Riverdale, UT 84405
Cell: 307 -286-527 0
afgonzales7 5@gmail.com
Veteran seeking employment within a Medical Facility or Medical Insurance Agency that will use my
expertise in Provider Credentialing
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HIGHLIGHTS OF QUALIFICATIONS
 Perform primary source verification on providers credentials
 Established excellentorganizational skills &attention to detail
 Scheduling and holding monthly Credentialing Committee meetings with Medical Director and
members ofCommittee
 Work closely with provider and office management on credentialing
 Organization and storage ofprovider files to includeonline filling
 Proficient in data-input &office equipment operations
 Review & input ofinitial entry and re-credential ofproviders and facilities
 Review files for correct procedures on delegated credentialing
 Follows NCQA accreditation standards in credentialing ofproviders and facilitie s
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EXPERIENCE
WINhealth Cheyenne, WY
Credentialing Specialist 6/2013–Present
 Perform Initial Credentialing, Re-credentialing,and Mid-cycle checks on providers
 Review of Facility Delegated Credentialing records for discrepancies
 Perform Primary Source Verification on websites for Providerand Facility Credentialing
 Work closely with ProviderServices and MemberServices personal to accomplish needed tasks
 Perform Updates and Terminations to computer files
 Identify issues and report to Medical Directorfor review
WINhealth Cheyenne, WY
Medical Managem ent Coordinator 1/2011–7/2013
 Initiated authorizations for medical careto members for officevisits and procedures
 Responded to questions and inquiries from providers and members regarding authorizations and
assist members with referrals to programs and providers
 Provided first and second level review to ensure efficient and quality care
 Identified and resolveddisputes from members and providers
 Provided administrative support by processing pharmacy overrides basedon authorization and
established guidelines
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EDUCATION
Institute ofBusiness &Medical Careers
Associate ofOccupational Studies Degree, Billing and Coding Cheyenne, WY
6/2010
 Honor Roll Student, GPA 3.7 5 Dean's List
 Certified Medical Billing Specialist Dec 2010
 Knowledge in Medical Terminology and Anatomy
 Comprehension ofCPT, ICD-9-CM, HCPCS
 Familiar with CMS-1500, EOB, SOAP notes & office procedures

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SKILLS
 Bilingual in the Spanish language
 Proficient Microsoft office , Medisoft, Centricity and IntelliCred, Monument Express
 Type 36 words per minute
 Skilled in problemsolving &time management
 Managing multiple responsibilities &tasks efficiently
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LICENSES/CERTIFICATIONS
 Certified Medical Billing Specialist Dec 2010
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HONORS/AWARDS
 Honor roll Student, GPA 3.75 Dean's List
 20 Y ear Retired Veteran USArmy/Utah Army National Guard
 Honorably discharged
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REFERENCES
Available upon request