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Claim Assistant Specialist Resume Profile

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SC

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Summary:

Detail oriented and quality focused professional with several years of billing and insurance experience. Highly skilled with reconciling patient payments and resolving account disputes. Proficient in multiple software applications.

Telemetry Technician Certified

Skills and Training:

  • CPR Certified
  • HIPAA/ OSHA Trained
  • ICD-9, CPT, HCPCS Codes
  • Claim Submittal and Follow Up
  • Insurance Billing Knowledge
  • Medical Form Completion: UB-04 and CMS-1500
  • EHR and Medical Record Maintenance
  • Microsoft Excel, Microsoft Access and Trac-G

Work Experience:

Confidential

  • Maintain compliance regulations while working closely with other departments and outside associates to find resolutions before application are completed and/or claims are processed
  • Processing and verification of incoming documents for new business applications and/or claims received. for potential compliance issues
  • Enter annuals premiums, verify rates organize agent data, assigned files from workflow/inventory tracking systems, and compile required information into set files using read and identify errors that could occur during file loading

Claim Assistant Specialist- Confidential

  • Assist claims examiners with processing of claims.
  • Made outgoing calls to employers and providers to obtain information for claims processing.
  • Performed clerical duties, such as faxing, copying, emailing, etc.

Advisor Internship

  • Utilized external client systems to access patient account information on a daily basis, and document activity.
  • Accessed medical records, EOBs, and updated HCPCS condition codes while adhering to HIPPA regulations.
  • Faxing, printing, mailing, or calling the insurance company or patient if needed.

Confidential

Medical Billing and Coding

  • Scheduled patients using Zoom software by EdgeMed, and collected prescription information as needed.
  • Entered patient information, took payments, and issued receipts using Lytec Medical software.
  • Answered phone and directed messages to appropriate party.

Confidential

Billing

  • Contacted individuals with delinquent medical accounts via phone and mail.
  • Collected and applied payments documented all calls, transactions, and adjustments.
  • Generated revenue by ensuring customer collections in a timely manner per company policies and procedures.
  • Confidential
  • Resolved transactions regarding customer service and technical support issues maintained the upkeep of pertinent files.
  • Tested software and hardware to verify if products were beneficial to users.
  • Met established individual and team performance targets which included customer service, and quality standards.

Confidential

Customer Account Specialist

  • Answered phones, greet customers, and received/ processed credit and employment verifications.
  • Processed insurance products at the direction of a licensed agent, handled mail, notarized, recorded, and filed documents.
  • Performed routine transactions by processing payments and disbursements while preparing reports, and maintained updates of customer files.

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