SPECIALISTS Resume

SUMMARY

TX As a Claims Adjuster Specialist I answered incoming phone calls from State Farm insured, Claimants, appraisal, and other people regarding information about the accident.
I issued paymentsclaims to insured, Claimants, body shop and other parties involved as needed.
I determine liability on claims. Also alot of other daily task.

TECHNICAL SKILLS

Skills & Abilities Microsoft Office: Medisoft, Meditech, Connance, SSI, HPF, Customer Service, Editing/Filing, OSHA. PCON, HIPAA trained in rules and regulations.

Ten - key: 45-50 wpm typing, A/R follow-up, Processing Refund Checks, ICD 9/10, CPT, HCPCS, Medical terminology, highly efficient in Medicare/Medicaid Guidelines & reimbursement guidelines, NextGen, Emdeon, Navinet, CPSI, Flow cast, Centricity, Athena, EWS, Allscript, E-Commerce, EPIC, CUBS and Meditech.

PROFESSIONAL EXPERIENCE

SPECIALISTS

Confidential

Responsibilities:

A/R reports for credit balances, worked in collections and validations, handled paper and electronic correspondence letters. Assisted in root cause reports and other special projects assigned from upper level management. Worked with multiple payer websites.
Handled insurance calls. Worked with In Confidential t, Rehab, Psych and SNF CMS priers and APC fee schedule pricers. Handled Timely filing and Underpayment appeals. Handled PCON issues. Worked hand and hand with our cash team department retrieving check remittances to post. MANAGED MEDICARE COLLECTIONS Confidential
A/R reports for debit balances, worked in collections and validations, handled paper and electronic correspondence letters.
Assisted in root cause reports and other special projects assigned from upper level management. Worked with multiple payer websites.
Handled insurance calls. Worked with In Confidential t, Rehab, Psych and SNF CMS priers and APC fee schedule priers. Handled Timely filing and Underpayment appeals.

ASSOCIATE

Confidential

Responsibilities:

A/R follow - up and review for Medicare, Medicaid and Commercial insurance appeals and follow-up.
Claims filing, appeals and follow-up. Talk with insurance companies or Confidential ts as needed. Manage, assist and complete special projects as given.
Handling incoming emails and calls.

SPECIALIST

Confidential

Responsibilities:

Physicians A/R follow-up and review. Medicare, Medicaid and Commercial insurance appeals and followP up for multiple provider practices.

We provide IT Staff Augmentation Services!

We'd love your feedback!

Resume Categories

Client Services

Job Seekers

Visa Sponsorship