Customer Service Insurance

Reid A. Seamans

**** *.*. *** ******* Miami, FL *3134

305-***-**** ********@*****.***

PROFESSIONAL GOAL

To obtain a position in the healthcare support industry applying my 10 plus years of customer service and

supervisory experience and education.

ADDITIONAL EXPERIENCE

2010 – 2012 Production Cook - Panera Bread Coral Gables, Fl

2009 – 2010 Line Cook - Sir Pizza Miami, FL

2008 Sales Representative - AT&T Corporation Miami, FL

2006 – 2008 Assistant Manager - Domino's Pizza Coral Gables, FL

2006 Enrollment Specialist - Alorica (Formerly PRC) Miami, FL

RELEVANT EXPERIENCE

Miami Dade County Health Department Doral, FL

Billing Specialist 2005 to 2006

• Served five clinics in Miami - Dade county

• Performed billing for Dade county health clinics

• Posted approximately 35 patients’ Medicaid/Medicare and HMO payments daily

• Processed approximately 50 denials per day from private, commercial, and governmental

insurances for nonpayment

Argent Healthcare (Formerly Paralign Revenue Management) Miami, FL

Account/Customer Specialist 2004 to 2005

• Processed 50-60 private and HMO insurance claims for hospitals and clinics daily

• Utilized two computer programs simultaneously (FACS to enter and edit patient information and

Premis to bill clean claims electronically to insurances using the standard HCFA 1500 form)

• Represented hospital in seeking payment from self-pay patients using a predictive dialer

• Followed up on insurance payments from commercial, private, auto, and worker’s compensation

• Collected insurance payments from two client hospitals after the primary insurance had paid and

then billed Medicaid as a supplement to the primary

Per-se’ Technologies Miami, FL

Billing/Collection Specialist, Customer Service 2002 to 2003

• Received one hundred calls daily regarding customers’ bills and reasons for nonpayment from the

insurance company, issue was resolved by updating the insurance that was on file and re-filing the

claim for payment to the insurance

• Followed up on Anesthesiology insurance claims sent electronically to managed care, private, and

commercial insurances

• Filed secondary insurances using the EOB from the primary for additional payment

American Medical Response Miami, FL

Insurance Specialist 2000 to 2002

• Handled all correspondence/denials from the HMO insurances

• Processed multiple insurances including United Healthcare, Cigna, and Humana and utilized AM

2000 to view denial of payments and re-file claims via internet when applicable

• Appealed claims denied for no authorization and, if coded incorrectly, corrected and resubmitted

to insurance for processing

• Entered ambulance trip tickets by mail and electronically as recorded by the Paramedics/EMT’s

SKILLS

• AM2000, Facs/Premis, Medical Manager, and Medisoft

• Proficient and qualified in Data Entry over 9000 keystrokes per minute

• Proficient in Microsoft Word, Excel, and PowerPoint

Education

Bachelor of Business Administration 2012

American InterContinental University Hoffman Estates, IL

• Concentration: Management

Associate of Science in General Studies 2009

Colorado Technical University Colorado Springs, CO

• Concentration: Management

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