Michael Touma has over 15 years of experience in various clerical and medical office roles. His experience includes medical billing, scheduling, utilization management, and data entry. He is proficient in Microsoft Office, medical billing software, and translating between ICD-9 and ICD-10 codes. Touma has a Bachelor's degree in Liberal Studies and an Associate's degree in Social Science. He is fluent in Spanish and seeks an office clerical position.

1. July 2014 - December 2016
October 2013 - June 2014 (Contract)
February 2012 - December 2012
Michael Touma
1004 Ellen Ln. El Cajon, CA 92019
(909) 261-5007 • michaelctouma@gmail.com
Objective
To obtain a clerical office position.
Work Experience
Medical Biller
Rehab Solutions, Irvine, CA
● Bill and manage monthly supplies for interferential unit (Worker's Compensation)
patients
● Re-bill unpaid claims
● Total all charges to each insurance company
● Process charge adjustments and reverse charges on returned supplies
● Translate ICD-9 codes to ICD-10 codes
● Update patient insurance information
● Stop the distribution of supplies on settled cases
● Process all incoming orders for billing
● Process proof of service for all claims
● Process weekly reports for all outgoing supplies
● Assist in writing the Company's billing manual
Medical Scheduler/Collector
Sovereign Healthcare, Mission Viejo, CA
● Data Entry on patient demographics, health plan, process and finalize medical
verifications
● Medical Billing
● Monitor HMO patient authorizations approved or pending for outpatient surgery at an
ambulatory surgical center
● Contact patients to notify co-pays due, facility fees for surgery at time of service;
organize payment plans
● Verify patient health plan eligibility and benefits online and telephone with a live
representative
Utilization Management Coordinator
Sain Joseph Hospital Affiliated Physicians, Anaheim, CA
● Analyze and process referrals for durable medical equipment
● Verify benefit coverage and patient eligibility for durable medical supplies and
equipment
● Approve and deny authorizations for patients based on medical necessity
● Coordinate physician referrals for surgeries, consultations, and follow-ups for patients
● Process doctor orders for date extensions and adding requested procedure codes
● Verify patient benefits and eligibility for optometry, physical, speech and occupational

2. February 2002 - October 2011
September 1993 - June 1996
September 1990 - August 1993
therapy
● Receive and direct phone calls; perform clerical, filing, and fax medical authorizations
● Communicate with Case Managers on patients acquiring hospice and senior care
Medical Biller
Westcliff/Labwest Medical Laboratories, Santa Ana, CA
● Perform data entry on medical requisitions, specializing in Medi-Cal, Presumptive
Eligibility, and Family Pact
● Verified patient Medi-Cal eligibility online, if patient card is out dated or no ID card
provided
● Checked for narrative diagnosis description, resending requisitions for numeric ICD-9s
● Updated any changes for patient information
● Research patient medical information and insurance eligibility under HIPAA
guidelines
● Proofread doctor ICD-9 codes for accuracy, research on narrative description
diagnosis, verifying with doctor’s office for correct code(s) Process insurance claims in
a timely manner and provide follow-ups for HealthNet, Cigna, BlueCross, Medicare,
Medical healthcare agencies along with Medi-Cal group
● Enter and update patient information including addresses, insurance, and ICD-9
coding
● Provide customer service to patients, doctors’ offices, and insurance companies
Education
Bachelor of Arts in Liberal Studies
California State Polytechnic University, Pomona
Associate's Degree in Social Science
Citrus College
Languages
● Spanish (fluent)
Technical Proficiencies
● Microsoft Word, Excel, Power Point
● Advantex, Xifin, IDX