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Title Senior Associate Medical Claims
Target Location US-FL-Orlando
Email Available with paid plan
Phone Available with paid plan
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Candidate's Name
Senior AdministratorStreet Address
PHONE NUMBER AVAILABLEKris I EMAIL AVAILABLEHighly motivated and committed Senior Associate with proven history of superior performance at individual, team, and organizational levels. Multitasks and prioritizes workloads with little or no supervision. Detail-oriented professional looking to bring my current skills and team-building knowledge to a deadline driven environment. Effective Senior Associate with a strong background building rapport with team members and outside associates alike. Driven performer equipped to handle multiple, administrative tasks effectively. Exemplary worker with high investigative / research skills when completing assignments.Work History09/2022 - Current Montverde Academy Senor Medical Associate Montverde Florida Schedule appointments, register patients, and distribute pharmaceuticals as prescribed. Obtain client medical history, medication information, symptoms, and allergies. Complete clinical procedures and gather patient data for interpretation by physician. Document vital signs and health history for patients in clinic and hospital environments. Call and fax pharmacies to submit prescriptions and refills. Collect and document patient medical information such as blood pressure and weight. Keep medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted. Sanitize, restock, and organize exam rooms and medical equipment. Perform medical records management, including filing, organizing, and scanning documents. Verify patient insurance coverage and collect required co-payments. Answer telephone calls to offer office information, answer questions, and direct calls to staff. Conduct monthly and quarterly inventory of supplies using facility cost reporting records. Reconcile all expenses coming into and going out of the Infirmary. Plan and organize as well as conduct meetings on care, expenses, improvements happening within the Infirmary Staff Schedule Infirmary Staff for all upcoming events where medical staff will be required. Work hand in hand with the Academy Athletic trainers on improving the care and experience for our boarding students. Work with Academy Associates on scheduling all big sporting events that take place on campus. 06/2011-08/2022 GEl-IA - Senior Medical AssociateIndependence Missouri Examined claims forms and other records to determine coverage for claim audit. Answered customer questions regarding coverage. Paid, denied, and audited medical claims based upon established claims processing criteria. Used administrative guidelines as resource or to answer questions when reviewing medical claims. Managed large volume of medical claims on daily basis. Responded to correspondence from insurance companies, providers, and facilities. Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures in alignment with HIPAA regulations. Identified and resolved discrepancies between patient information and claims data. Assessed medical claims for compliance with regulations and corrected discrepancies. Monitored and updated claims status in claims processing system. Verified patient insurance coverage and benefits for medical claims. Processed insurance payments and maintained accurate documentation of payments. Supervised a 12-15-person team within the claims department. Scheduled and planned employee coverages to ensure all shifts were covered. Maintained employee reviews submitting promotion approvals when applicable. Trained up and coming claim auditors.08/2019 - Present Arrowhead South - Orlando Chapter I'm also the director and organizer of an 800-member group that meets weekly. I plan all events from hotel stays, meals, and travel. I work closely with group members, ensuring their satisfaction from start to finish when it comes to game day experience and everything leading up to game time. I work closely with past players to schedule / plan meet and greet opportunities as well as making sure their needs are met with travel, meals, and transportation. I work closely with all venues to ensure proper set up and accommodation are met. I plan yearly charity events within the group that benefits different organizations within the national football league. I also run all social media pages for the Orlando chapter.Education:2003 - Graduated from William Chrisman High School receiving a diploma 2004 - Studied Business Administration at Maple Woods college 2010- Completed EMT / Paramedic Training through AMR First Responders Service / Certificate 2024 - Completed Medical Billing and Coding through Florida Technical College / Certificate References:Tiffani Law - Montverde Academy PHONE NUMBER AVAILABLENoelle McQuinllin - Arrowhead South PHONE NUMBER AVAILABLEMelanie Williams - GEHA PHONE NUMBER AVAILABLEMorgan Quattrociocchi - Arrowhead South Perner #00737997

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