OBJECTIVE:

To obtain a career from a reputable company where I can use my skills and experience effectively to proficiently become fluent and advance in every functionality of the business.

SUMMARY:

• I am very enthusiastic to apply for the position you currently have available. My employment history and educational background have provided me with the required skills and a solid foundation to perform this job successfully.
• I have at least 8 years of recent experience specific to medical billing and claims resolution:
• Experience working from and understanding EOB's
• Follow - up with health plans and patients to resolve the accounts
• Detail-oriented when entering claims
• Excellent written and verbal communication skills
• Demonstrate exceptional customer service skills
• Proficient with various software applications (Outlook, Excel, Word) and practice management system
• Self-motivated and able to work independently as well as part of a team
• The scopes of my responsibilities have required a proficiency in automated systems such as: PARAGON, TPA, AVAILITY, and ZIRMED, and an expert knowledge of medical billing and HCPCS/CPT / ICD9 coding for diverse medical specialties.
• In addition to customer service and managing medical billing activities, I have extense insurance knowledge concerning laws and state/federal guidelines and regulations. As a result of my knowledge, I have met and exceeded company quotas and have also experienced a significant increase in productivity and timely submission and payment of medical claims.
• It is this experience that I would like to bring to your company in a position as a medical billing specialist.
• If you feel there is a mutual interest, I would welcome the opportunity to meet with you to learn more about your company, the requirements of the position, and how my qualifications would be a good fit.
• For your review, I have attached my resume for your consideration. Thank you in advance for your time and consideration.

WORK EXPERIENCE:

Confidential, Louisville, Kentucky

Responsibilities:

• Follow- Up on insurance and patient payments for the 5 Baptist Facilities.
• I also verify and check patient’s eligibility for commercial and government insurance.
• I assist in billing corrected UB and 1500 claim forms in conjunction with Government and State filing guidelines.
• I have experience in book keeping as far as adjusting the accounts via Account Receivables to patient balances in order to reflect correct insurance contract adjustments and payments, charity contributions given to patients by our facility.
• I worked all VA (Veteran Administration) accounts to include billing (initial and correction), correcting and posting payments and contractual adjustments, as well as, assisting with denials and appeals to the VA on the behalf of the patient and facility.

Customer Service

Confidential, Louisville, Kentucky

Responsibilities:

• Follow- Up on the billing of 1500 and UB claim to insurance for all 5 Confidential facilities as well as collect prospected payments due to the patient’s accounts.
• I assist with directing payments that are received via bulk remittances and make adjustments on accts that post payments incorrectly according to EOB.

COBRA and HSA Representative

Confidential, Louisville, Kentucky

Responsibilities:

• COBRA and Health Savings Representative- processed claims for Federal Employees and maintained accounts for prompt reimbursements to clients

Administrative Assistant

Confidential, Indianapolis, Indiana

Responsibilities:

• Greet public and refer clients to appropriate staff members, answer phones (multi lined), route calls, and take messages.
• Assist staff with administrative duties as requested.
• Type and word process documents as needed, order office supplies and monitor inventory, update and maintain mailing lists, facilitate special event registration and execution, and maintain interpersonal relationships with employees, peers, and consumers.

Sr. Customer Care Specialist

Confidential, Louisville, Kentucky

Responsibilities:

• Inbound and outbound customer service; answer calls from Humana members concerning their COBRA, Original Medicare, Medicare Replacement and Confidential coverage, as well as other coverage that is obtainable thru Confidential .
• I have extensive claims interpretation skills using the HCPCS, CPT, and ICD-9 codes as submitted by our third party providers describing services, using either UB or 1500 claim forms for medical services, and experience with pharmacy claims as far as verifying NDC and BIN that will aid or hinder processing of claims, and authorizing medications using the correct dispensing limits warranted by the Confidential .
• I was promoted to a special projects team that handled grievances that were submitted by our clients via phone, email and fax, expressing their dissatisfaction with our company (customer service issues, unable to locate service in their area, or improper payments for services) and appeal claims that were denied.

Customer Service and Sales

Confidential, Louisville, Kentucky

Responsibilities:

• Handled client relationships and manage accounts, which included promoting enduring relationships with a diverse clientele, and increasing retention as well as satisfaction rates and sales compliance.

CSR/Customer Resolution Specialist

Confidential, Indianapolis, Indiana

Responsibilities:

• Inbound and outbound customer service: start as customer service rep, and was promoted as a Resolution Specialist after 6 months of employment.
• I was the acting liaison between our customers, third party contractors, and manufacturers via email and the Internet.
• I also have experience with excel and Microsoft word, as well as people-soft database usage, corp.
• PC usage, direct connect for contacting service tech, scheduling and maintaining technicians daily schedules, as well as product management for the company.

Administrative Assistant

Confidential, Indianapolis, Indiana

Responsibilities:

• Responsible for complete project life cycles, including requirements determination, technical planning, scheduling, design, implementation, testing, and post-implementation support, answer corporate phone lines and answer management email