ANDREA JASPER

*** ****** ***, ***. ***, Brooklyn, NY 11221

Cell: 347-***-****

E-mail: acn1ja@r.postjobfree.com

QUALIFICATIONS

Knowledge: Microsoft Windows, Microsoft Word, Excel, Accounting, IDX, ICD-

9 Coding

PROFESSIONAL EXPERIENCE

EmblemHealth

10/2011-02/2014

New York, NY

Claims Specialist

Duties & Responsibilities:

Review, investigate and adjudicate professional and/or facility claims

(majority of claim types/specialties/LOBs) according to line of business

and benefit plans.

Process claims in accordance with corporate policies and procedures

including but not limited to provider contracts, single case agreements,

claims re-pricing and code review guidelines.

Understand the relationship between eligibility and benefits for accurate

claim processing.

Identify (and send to COB department) claims that require investigate

claims COB/third party liability/subrogation as part of the adjudication

process.

Physician's Choice Medical Billing.

08/2010-09/2011

Freeport, New York

Billing Assistant

Duties & Responsibilities:

Billing outpatient claims to Commercial, Medicare, Medicaid, Workers

Compensation and No-Fault Insurances.

Post payment, denials, write-off posting, perform accurate ICD-9 and CPT

coding in system. Follow-up on unpaid claims with insurance company.

New Beginnings Enterprises

January 2004-July 2010

Hempstead, New York

Secretary

Duties & Responsibilities:

Filing, scheduling appointments, typing, maintaining proper records, data

entry, answering heavy volume phone calls, provided information to visitor

satisfaction.

Work closely with my department and peers by resolving issues speedily,

clarifying information and performing reports to my manager on a

daily/weekly/monthly basis.

Contact this candidate