B EVERLY S. COONEY

**** ******* *****

Oldsmar, FL 34677

727-***-****

acdgja@r.postjobfree.com

EXPER IENCE:

NOVEMBER 2000 – MARCH 2013: Eligibility Analyst at U N I TED HEALT H CARE,

O ldsmar, Florida.

• Maintain eligibility data on the appropriate systems for claims processing and

administrative functions.

• Respond to eligibili ty related questions from internal/external customers.

• Provide resolution to service requests (National Pend Queue and Ors)

• Analytical and researching techniques to t rend or quantify projects

• Ini tiate and assist with developments/changes to increase or change quality and

p roductivity

• Preparing, processing, and maintaining new member or group enrollments

• Reconciling eligibility discrepancies, analyzing t ransactional data & submitting

retroactive eligibility changes

SEPTEMBER 1998 – OCTOBER 2000: B illing Supervisor at H EALT HSOUT H,

C learwater, Florida.

• Supervisor of billing and staff of five

• Responsible for billing of 13 facilities for work comp, private insurance, private pay,

and company account

• Responsible for maintain physician data base

• Work with payer relations to resolve credentialing issues with insurance carriers

Team Leader of Patient Accounts Department:

• Responsible for supervision of Patient Account Reps for five major facilities for

collections

• Responsible for all billing and collection functions necessary to obtain

reimbursement of charges generated from patient t reatment

• Act as liaison with clinical staff, patients, workers comp, insurance companies and

various companies as needed to insure capture of charges

SEPTEMBER 1996 – JUNE 1998: A dministrative Assistant at T HE UN I VERSI TY OF

M ED IC I NE AND DENT ISTRY OF NEW JERSEY, ROBERT WOOD JOHNSON

U N I VERSI TY HOSPITAL – T HE BOGGS CENTER, Piscataway, New Jersey.

• Responsible for assisting Program Directors in preparation for Supported

E mployment Training

• Schedule meetings, appointments, and conference calls, t ravel, t raining

sites/materials

• Maintain system to register and confirm participants in UAPNJ Statewide t raining

workshops and conferences

• Prepare expense reports, quarterly status reports and grants

Benefits Specialist in Human Resources:

• Assisted the Director of HR recruiting physicians, verifying credentials, setting up

physicals

• Enrolled employees into the Health & Dental plans and processed changed to

coverage. Prepared Cobra Notices for continued coverage. Worked on benefit related

p rojects.

D ECE MBER 1995 – JUNE 1996 : Administrative Assistant for W ELL INGTON

M ANAGEMENT COMPANY, Wellington, Florida.

• Responsible for assisting Deed Inspector in maintaining properties in Wellington,

u nder the deed restrictions of the Homeowners Association “First Wellington”

• Processed violation correspondence and issued fines to property owners resisting

compliance with restrictions. Monitored and input data on community violation

system

• Directly communicated with property owners to extent time to correct violations and

to issue permits for fences, pools, satellite dishes based on the by-laws of sub-division

DECE MBER 1989 – JUNE 1995: Tech Analyst/Contract Analyst for M E TL I FE,

H auppauge, New York.

• Reviewed and processed beneficiary changes, absolute assignments and life

conversion applications

• Responsible for preparation of contractual material in compliance with Contract

B ureau Directives, state insurance laws and regulations

• Prepared certificates and policies

JANUARY 1988 – DECE MBER 1989: Billing Technician for ST. FRANC IS HOSP ITAL,

I NC ., Memphis, TN.

• Responsible for billing and collections of Medicare/Medicaid and Commercial

I nsurance patient accounts

• Directly communicated with Medicare/Medicaid personnel and Commercial

I nsurance Companies

• Investigated accounts in detail which involved direct patient communication using

CPT-4 / ICD-9 codes

APR IL 1981 – DECE MBER 1987: Operations Consultant for M E TL I FE, Hauppauge, New

York.

• Responsible for assisting sales reps in the issuance of new policies and

administration of existing accounts

• Loaded all coverage information into Inforce and Metfacs systems

• Communicated with customers, sales reps, various internal units and answered 800

customer service line regarding coverage

EDUCAT ION:

H igh School Diploma, June 1979 – Sayville High School, Sayville, New York

COMPUTER SKILLS:

W indows, Microsoft Outlook, M icrosoft Word, M icrosoft Excel, Office Communicator

REFERENCES:

Available upon request

Contact this candidate