Karen Leedom **** Westridge Dr . Oceanside, CA ***56 . 760/207-9826

QUALIFICATIONS

HIGHLY QUALIFIED HEALTH INSURANCE SPECIALIST with strong record of

performance-based promotions. Demonstrated ability in fast paced/high

volume environment. Very analytical with exceptionally good investigational

skills; quickly discern discrepancies. Extensive experience in:

Supervising staff; updating personnel on new procedures. Medical

claims processing. Medical claims billing and collections. EDI

processing, HIPAA guidelines, ICD9 coding.

Strong customer relations skills, recognized for ability to resolve

problems and maintain client retention. Adept at communicating with insured

clients, medical professionals, and insurance providers. Committed to

company goals; consistent "overgoal" performance. Team player. Excellent

organizational and time management skills.

EMPLOYMENT

EA Health Corporation

2007-Present

Accounts Receivable Specialist

Responsible for accurately submitting anesthesia claims according to

payer specific guidelines. Review Medicaid claims /correct coding

errors prior to submission. Review and correct certain coding denials.

ICD9 coding for GME/DIB doctors. Responsible for all coding changes

in billing system received from coders. Monitor all claim errors in

billing system to include billing, enrollment and coding department/

report to Billing Operations Manager any patterns detected or untimely

corrections.

The Plan Handlers, Inc.

2002-2007

Claims Analyst/Trainer-Auditor/ Technical Support Supervisor/Assistant

Claims Manager

Performed overall medical claim processing ~ Promoted to

Trainer/Auditor; Trained new hires for Claim Department and Customer

Service. Audit large dollar claims for accuracy of payment. Ongoing

training with audit results ~Promoted to Supervisor of Technical

Support Department to include the filing, collecting and posting of

Reinsurance claims, prepare disclosures and update reports for Client

Services Director ~ Promoted to Assistant Manager. Managed the

Claims/Customer Service Department, concentrating on excellent

customer service and reduction of backlog. Managing onsite office of

25 employees and offsite office of 8 employees.

Providence Systems, Inc. 2000-2002

Marketing Representative

Responsible for marketing events for Real Estate seminars. Daily

contact with professionals in the Real Estate, Lending, Insurance, and

other fields who could benefit from Referral business.

The Plan Handlers, Inc. 1999-2000

Claims Analyst

Performed medical claim processing for several self-funded groups.

Provided daily customer service to

insured clients and medical providers.

Primary Care Associates 1997-1999

Claims Auditor

Ran daily reports of claims processed and reviewed for accuracy of

payment. Provided ongoing training in areas of concern. Reviewed and

resolved member/provider complaints. Daily contact with insurance

companies for claim payment resolution in an IPA setting.

Pro-Intermed 1995-1997

Medical Insurance Representative

Provided billing and collection of HMO and PPO claims to various

clients. Performed daily contact with Insurance companies to determine

claim payments, accuracy of payment and investigate non-payment of

claims.

The Principal Financial Group 1985-1995

Claim Examiner, Training Supervisor, Claim Supervisor, Account

Representative

Performed overall medical/dental claim processing. Trained new staff

on claim processing fundamentals; worked with Home Office to set up

new claim paying system/training. Resolved member/provider complaints.

Provided quotes and marketing material to potential clients in Sales

Office environment. Daily contact with

Brokers/Clients during implementation of group set up. Ongoing

communication to insure client retention.

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