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Click here or scroll down to respond to this candidateCandidate's Name
Foley, AL PHONE NUMBER AVAILABLE EMAIL AVAILABLESummaryI am a detail-oriented Billing Claims Reviewer with an emphasis on ensuring the job is done correctly. I have experience with 1st and 3rd party billing and claims in the medical industry, and specialize in working with attorneys, providers, and hospitals. Going forward, I am seeking a Billing Claims Reviewer role where I can use my skills, knowledge, and training to contribute to a company such as yours. ExperienceAuto Injury Solutions (CCC Intelligence Solutions), Daphne, AL (7/10/2010 6/30/2023) Outbound Customer Service (7/10/2015 6/30/2023) Analyzed and reviewed insurance claims to ensure adherence to company policies, HIPAA regulations, and healthcare laws Ensured that name, Date of birth, claim number, date of loss & address match; move to appropriate bins for processing or indexing, ensuring that adjusters can contact their providers and maintain accuracy in the billing and claims process Met correspondences needs by collecting patients name, claim number and/or date of birth and city/state and/or date of loss or loss report number if dol is missing Reviewed and Processed CMS 1500 and all related forms from healthcare providers, enabling billingWorked with healthcare providers or attorneys to collect missing information and correct inconsistencies or inaccuracies in claims Partnered with third parties within the company to collect missing tax identification numbers and/or correct addresses for billing purposesInbound Customer Service Representative (7/10/2010 7/10/2015) Managed high-volume inbound calls, taking up to 50-60 calls per day, and maintaining a consistency positive and professional demeanor to ensure a positive customer experience Answered incoming calls from Providers, Patients and Claims Adjusters Looked over claim status to see if claim is processing, paid or pending Leveraged knowledge of medical billing coding to resolve issues Maintained high data accuracy by taking extensive, detailed notes of all accounts and claims Completed call backs to providers or patients to follow up on unresolved issues CPSI, Mobile, AL (10/1/2009 3/1/2010)Claims Follow-Up Agent Made calls to different insurance companies for different Hospitals to check claim status as to whether claims are processing, paid or pending Maintained high data accuracy by taking extensive, detailed notes of all accounts and claims Completed call backs to providers or patients to follow up on unresolved issues Re/Max of Orange Beach, Orange Beach, AL (5/1/2003 10/1/2008) Administrative Assistant Organized the office with care and detail, worked effectively alongside Employers Filing, Greeting of the public, answering the phone lines, working copy and fax machines daily Typed up listings and purchase contract for homes, land and condominiums Responsible for inputting data daily into employers database on homes, land, and condominiums Worked on large mail-outs for Employer which included distributing and collecting Worked on keeping clientele information up to date for Employer, including names, address, phone numbers, email, etc.Magnolia Springs Wesleyan Church, Magnolia Springs, AL (6/1/1990 9/1/2001) Personal Secretary to Senior Pastor Typing and computer skills used as well as working up PowerPoint presentations for Sunday services (am and pm) Typed up sermons and worked up music to distribute for music leaders for Sunday mornings Worked up a newsletter to distribute by mail once a month to members and non-members (bulk mail-outs) Paid bills twice a month for Treasurer Greeted public, answered the phone, took messages, worked copy and fax machines daily EducationRemington College, Mobile, AL, January 2009 to October 2009 Diploma, Medical & Coding Graduated with Honors: Presidents list all 8 months while attending classes Albertus Haasdijk Outstanding Student Award Presidents list - 4.0 GPAMedical Billing and Coding: Achievements & Certificates Perfect Attendance HIPAA - The Privacy Rule and Health Care Practice Certificate - February 19, 2009 HIPAA - Security Basics for the HealthCare Workforce - February 19, 2009 Certificate, Blood Borne Pathogens in the workplace - January 27, 2009 Skills & Qualifications Administrative Assistant, Personal Secretary, Receptionist Typing (60-70 wpm) and computer skills, including working with powerpoint Worked with Microsoft Publisher, Word Perfect and Excel Organizing the office with detail and care - working well with others within the office atmosphere Knowing the long and short terms goals of the company I am working for Greeting the public, answering multiple phone lines, working copy and fax machines daily Worked up large mail outs - typed organized and distributed Typed up contracts for real estate companies which included: listings, Purchases for land, homes, condos and any others that needed to be worked up for my Employer Billing specialist (incoming and outgoing) Made calls to different insurance companies for hospitals/providers to Check claim status on whether claim was paid, processing or pending Took detailed notes along with data entry for each claim worked Organizational skills and experience in patient account management Medical Office Management with Medical Coding and Billing guidelines Experience in Medical Transcription and advanced Diagnosis Coding Extensive HIPAA Training Experience in ALL AREAS of Current Procedural Terminology Coding References1. Mrs. Elizabeth Hauge - Auto Injury Solutions - Supervisor and Manager -701-212-3108 2. Mrs. Alicia Dugas - CPSI Supervisor and Trainer - 251-476-8210 3. Mrs. Becky Anthony Supervisor for 3rd party workflow / Jill Cortichiato Supervisor for IR Workflow4. Bill and Joanne Cranston - Re/Max of Orange Beach - PHONE NUMBER AVAILABLE and PHONE NUMBER AVAILABLE 5. Mike Cranston - Re/Max of Orange Beach - PHONE NUMBER AVAILABLE 6. Ms. Jenekia Thompson - Remington Instructor - 251-343-8200 7. Mrs. Michelle Birch - Remington Instructor - 251-343-8200 |
