Payment Specialist Resume Arizona - Hire IT People

PROFESSIONAL EXPERIENCE

Payment Specialist

Confidential, Arizona

Responsibilities:

Payment Specialist

Confidential, Arizona

Responsibilities:

Posted insurance and private payments to patients accounts for services rendered
Created spreadsheets for missing money that was sent to PCC for research
Reconciling teh day for close Training new posters
Identifying trends of denials that is sent to collections to research
Ensured appropriate claims for services provided were sent out timely to large insurance providers, third party administrators, and individual patients.
Met goals of billing out 300 to 450 claims per day
Ensured appropriate claims for services provided were sent out timely to large insurance providers, third - party administrators, and individual patients.
Consistently met company goal of successfully billing 500 claims per day.
Audited department reports to ensure that necessary claims were generated in a timely manner.

Payment Specialist

Confidential, Arizona

Responsibilities:

Posted insurance and private payments to patient’s accounts for services rendered.
Ran credit card checks to transfer funds and post payment.
Posted patient account information and explanation of benefits to internal system.
Responsible for manually and electronically filing clean claims to Medicare, Medicaid, large insurance providers, third-party administrator, and individual patients.
Audited patient accounts to ensure personal information was correct.
Verified patient insurance eligibility
Verified ICD-9 coding with providers to ensure claims are billed correctly
Worked special reports to clean up accounts with unresolved refunds. Processed and generated Medicare, Medicaid, large insurance carriers, and patient refunds as result of claim errors.

Enrollment Specialist

Confidential, Arizona

Responsibilities:

Verified member enrollment via telephone and computer system for PacifiCare members in Arizona, Colorado, and Nevada.
Reviewed new applications to verify health plan enrollment
Upon request, changed member’s electronic records to update PCP and hospital selection
Generated electronic and hard copy bi-weekly member enrollment reports and sent to internal sales department.