- Skilled at learning new concepts quickly while working well under pressure
- Ability to maintain organized records
- Ability to work quickly, accurately and independently in a fast paced environment
- Windows 2007 and higher; Windows NT
- Microsoft Office Suites
Member Services Representative
- Customer Service to members
- Computer updates (employee insurance)
- Process client files
- Generate correspondence
- Enter enrollment forms, declination forms, address changes
- Billing and follow - up of claims to Medicare
- Entered claims information into the processing systems
- Researched and followed-up of unpaid claims by using medical records
Medicare Provider Support Representative
- Processed and completed the following in accordance with Centers for Medicare Services guidelines: Internal overpayments (interoffice, Skilled Nursing Facility/Home Health Association, deceased beneficiary, system errors, and as a result of audits).
- Assisted coding and routing to third party providers
- Work aged account receivables, analyzes, determine appropriate action
- Verified benefits and claims payments information.
- Executed the full claim adjustment, started collection activities and ensure interest is assessed accurately.
- Answered multi-line telephone, routed calls, and took accurate messages
- Researched claims and corrected billing issues that dealt with the benefit and premium inconsistencies.