SHAWN EDWARDS-DUNN

acf3k3@r.postjobfree.com

919-***-****

OBJECTIVE: Obtain a challenging position, which enables a dedicated professional to exercise a high degree of initiative, judgment, discretion and decision-making to achieve department and organizational objectives.

PROFESSIONAL SUMMARY: Dedicated insurance professional with more than 5 years of experience investigating and processing medical insurance claims, reconciling insurance payments/patient patients and resolving disputes in an outpatient setting. Excel in analyzing claims, interpreting policies/procedures and negotiating payment solutions. Effectively manage multiple office locations, high-priority projects and take pride in providing exemplary customer service to patients and support staff

* Proficient in Microsoft Office products

* Follows compliance plan standards and department policies/procedures

* Effectively communicate through written and verbal forms of communication

* Medical Collections

PROFESSIONAL EXPERIENCE

EHP Behavioral Services LLC 2011 – 2014

Sr. Patient Accounts Representative

* Ensure that account follow-up and collection techniques meet laws, regulations and guidelines governing billing and collections in a outpatient health care facility

* Prepare and submit primary/secondary clean claims to various insurance companies electronically or paper

* Maximize collection productivity and accuracy by ensuring account follow up is done according to department collection philosophies and standards

* Process payments and reconcile daily batches

The Center For Cancer and Blood Disorders 2007 – 2009

Office Coordinator

* Conducted new patient intake to determine patient benefits

* Completed pre-determination/financial clearance for all new and recurring patients

* Reimbursement rate changes / fee schedule adjustments

* Performed charge entry and daily claims submission via electronic clearinghouse and paper claims

Hematology/Oncology Associates 2000 – 2007

Sr. Billing Specialist

* Supported billing manager processing a high volume of insurance claims according to federal regulations

* Posted and reconciled insurance and patient payments

* Prepare and submit primary/secondary clean claims to various insurance companies electronically or paper

* Outpatient/Facility Credentialing

* Train all new department staff

* Ensured compliance with policy provisions, state and federal regulations, and exercised expense management through investigation; appropriate follow up; case management and claim settlements

EDUCATION

Sawyer Business School

Certificate - Medical Billing & Coding

References Furnished Upon Request

Contact this candidate