Customer Service Insurance

Cathy Corbin

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

Shepherdsville, Kentucky 40165

Home 502-***-****

Professional Experience:

Weisskopf Child Evaluation Center-University of Louisville-October 2006-June, 2012

Billing Coordinator

1. Processed all electronic and paper claims and follow-up on all denied claims.

2. Obtained authorizations and referrals.

3. Resolved all issues pertaining to processing of claims with Passport, and Indiana and Kentucky

Medicaid, Medicare. Worked very close with provider representatives.

4. Obtained new physician and clinicians getting their CAQH and credentialing with insurance

companies as well as maintaining the current medical staff.

5. Assisted patient’s parents to obtain waivers and file appeals with their insurance companies.

6. Set up the office to file electronic claims submission to insurance companies for faster turnaround

on payments.

7. Processed and sent out billing invoices on special accounts hospital labs, school boards, clinics.

8. Software PACE and Centricity

.

Medical Society October 2005-October 2006

Patient Account Representative

Temporary assignments:

1. Follow-up on outstanding unpaid claims.

2. Sent corrected claims to insurance companies for reimbursement in a timely manner.

3. Obtained referrals and prior authorizations.

4. Audit EOBs for correct contracted rate.

5. Assist patients with all insurance questions and resolutions.

RX Crossroads August 2004-March 2005

Reimbursement and Insurance Verification Specialist

1. Insurance verification for the drug Amevive for dermatologists all over the United States.

2. Typed Certificate of Benefits and faxed to the physician’s office once insurance benefits were

obtained.

3. Collections on claims 30 days and older.

4. Appeal on claims that were denied by insurance companies for timely filing, procedure codes and

various other denials.

Fresenius Medical Care September 2003-June 2004

Patient account Representative

1. Collect receivables and monitor past due accounts. Research and resolve insurance claim discrepancies.

2. Coordinate all patient and insurance billing for the medical facility using UB92 claim forms.

3. Contact patient’s regarding outstanding balances and establish payment plan to maximize collections.

4. Process insurance payments to patient accounts in a computerized system.

5. Create and mail insurance claims in a timely manner to ensure

timely collections.

5. Rebill insurance companies and other third parties secure payment for patients.

6. Verify all entries and make corrections if necessary.

7. Respond to patient’s billing and statement inquiry.

8. Make recommendations to management for adjustments on accounts.

9. Software Medical manager.

Kentuckiana Pain Specialist August 2001–February 2003

Office Manager

1. Opened new practice and handled all business affairs and devised business strategies to

coordinate day to day business.

2. Handled personal matters, billing and collections, budgeting planning, equipment outlays and

patient flow.

3. Traveled to attend meetings and inspect satellite facilities. Attended required compliance training

with HIPPA, NCQA and CMS.

4. Schedules all procedures outpatient and in office, obtained insurance authorizations. Assisted with

procedures performed in the office, learned the mechanic of C-ARM (fluoroscopic guidance)

machine, assisted with procedures for seven months until a Registered Nurse was hired to assist

the physician

5. Filed HCFA 1500 and electronic claims. Handled all claim issues with insurance agencies, third

party and workman compensation and MVA claims. Increased patient growth from zero to greater

than 900 over a 19 month period.

Humana Inc. November 1998-August 2001

Grievance and Appeal Specialist

1. Investigate and research all complaints/appeals and grievances submitted via members and

providers.

2. Review all members and providers contracts to ensure benefits were adjudicated correctly.

3. Resolution such issues, inclusive of updating referral, waivers, precertification and pharmacy

authorizations and reprocessing claims.

Customer Service Case Coordinator I&II August 1996- November 1998

1. Manage high volume calls and correspondence in a prompt, courteous and professional manner.

2. Resolution of all customer service issues ranging from claim processing, enrollment concerns and

benefit interpretation/quotation of Humana group contracts.

Physician Coordinator April 1990-August 1998

1. Support Physician Advisors in their daily activities, typed all correspondence and diffused irate

callers.

2. Patient appeal preparations for physician review, clinical coding updates performed for claims

repayment.

3. Multiple software proficiency, inclusive of MacWrite, WordPerfect and Excel.

Alberto Maldonado, M.D. September 1989-April 1990

Medical Assistant

1. Assist physician with minor surgeries performed in the office. Set up all surgeries outside the

office, ensuring that all supplies needed would be available at the hospital prior to surgery.

2. Preparation of the operating facility and clean up after surgery. Escort patients to the examine

rooms: obtain H&P and initiate new and postoperative exams.

3. Take photographs, change dressings, remove sutures and staples, cast. Answered questions for

patients and family member’s regarding surgery and postoperative care.

4. Scheduled appointments, insurance filing and payment follow-up and all bookkeeping.

5. Typed all correspondence and contacted insurance companies for prior authorizations.

Denise Dickinson, M.D February 1986-September 1989

Medical Assistant

1. Assist physician with minor surgeries performed in the office, hospital and nursing home

consults.

2. Preparation for the surgeries and the cleanup and bandage of the surgical sites.

3. Scheduled appointments checked in and helped with new patients.

Education: Durrett High School Louisville, KY 1978

References and Letters of Recommendation available upon Request.

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