Customer Service Insurance

Angela F. Dalton

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

Colfax, NC *****

Home: 336-***-****

Mobile: 336-***-****

Objective:

To secure a position within a company where I can use my experience in Medical Insurance and Customer Service for the betterment of the company.

Summary of Qualifications:

Over 10 years of experience working with medical claims, insurance billing, and customer service

Strong ability to cope with emotional and mental stress

Great organizational, planning and time management skills, able to multi-task in a faced paced environment.

Energetic and positive attitude

Excellent written and verbal communication skills, very detail oriented

Professional Experience:

Medical Claims Processing, Jan 2002-March 2006

Aetna, Greensboro, NC

Responsibilities:

Process medical claims for Physician offices, Hospitals, and Diagnostics

Analyzed information received to determine if claims were payable

Maintained and updated information on insurance accounts

Determined primary payer and coordinated benefits for patients with multiple insurances

Medical Claims /Customer Service Specialist, April 2006-June 2009

United Healthcare, Greensboro, NC

Responsibilities:

Reviewed benefit coverage to determine if services were payable by insurance

Contacted clients for additional information need for claims processing

Kept detailed/accurate records to ensure proper claims payment

Resolved Insurance related problems related to denials, pre-authorization requirements, etc.

Accurately documented calls, received from customers, handled customer issues and escalated calls as needed.

Reimbursement Claims Specialist/Customer Service/Front Office, July 2009-August 2012

Battleground Urgent Care, Greensboro, NC

Responsibilities:

Direct Billed insurance companies for payment of patient services

Ensured services performed were covered services by contacting insurance companies and carriers

Researched information and resolved any unpaid insurance claim information for payment, worked denied insurance claims to receive payment

Determined and communicated with the patient any out of pocket responsibility for any services performed

Recorded charges and applied payment to patient accounts

Coordinated benefits for patients with multiple insurances

Entered charges, posted payment received from insurance companies

Worked and processed Workers Compensation Claims

Assisted front desk with answering patient calls, Scheduling, confirmation, and cancelling of appointments

Accurately documented calls received from customers, handled customer issues and escalated calls as needed.

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