Rosa Burgos has over 25 years of experience in healthcare and insurance claims processing. She has worked as a Patient Care Technician, Paramedical Examiner, Claims Adjuster, and Office Manager. She has a diploma as a Multi-Level Patient Care Technician and certifications in Phlebotomy, EKG, and CPR. Currently she works as a Claims Examiner investigating, evaluating, and settling workers compensation claims.

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.