Extensive experience in various health insurance support positions including customer service, Workman's Compensation, billling, claims processing, validator, major medical examiner, accounts receivable. Sound knowledge of State Commission Regulations and Managed Care payment requirements.
Sep 2010 - Present
Payment Research Specialist
Remedy Intelligent Staffing
Temporary position at Mutual of Omaha
Research and request Medicare Supplement policies for over payments, match online and physical payments to customer accounts, credit payments to accounts, and contact service representatives when needed.
Dec 2009 - Jun 2010
Reimbursment Support Representative
Answer incoming calls, organize and file documents, and compose and fax incoming and outgoing verbal and written communication for insurance claims, invoices, statements, reports, prescriptions and customer letters.
2007 - 2009
Patient Billing/Follow-Up Representative
Accurate and timely collection of all Third Party account balances, responsible for the billing cycle of three hospital clinics, reviewed and followed up with commercial accounts, documenation of payments and collections on unpaid balances. timely follow up and resolution of unpaid or denied insurance claims for assigned payers
2006 - 2007
Processed first report of injury claims.
2004 - 2005
Audited medical claim payments to identify incorrectly processed claims for overpayments. Calculated overpayment amounts. Documented other medical coverage and reviewed eligibility.
2002 - 2004
Processed overflow of Mutual of Omaha individual major medical health claims and reviewed policy provisions, deductiblies, coinsurance, policy exclusions and maximum benefits.