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Insurance Customer Service

Location:
Austin, Texas, 78758, United States
Posted:
March 02, 2011

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***** *****

*************@*****.***

Professional

Overview

Claims Assistant

with 17 years of

experience in

Professional

Liability, General

Liability, Auto,

Medical and

Workers

Compensation

Insurance. Areas

of expertise

include data

entry,

transcription,

accounts payable,

and customer

service.

Summary of

Skills

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Work Experience

Senior Claims

Coordinator

July 1993 to

January 2011

Texas Hospital

Insurance

Exchange/ Texas

Hospital

Association –

Austin, Texas

Sole

support

staff for

Vice

President

of Claims

and two

adjusters.

Assisted

in support

for two

other

adjusters.

Back up

receptioni

st.

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.

Reported new

claim/suit

information to

appropriate

agencies including

EDI, National

Practitioner's Data

Bank, State Board

of Medical

Examiners,

reinsurance

company,

Medicare/Medicai

d.

Entered all

payment

information in to

system for

payments of

settlement

checks, medical

payments and

expense

payments.

Received checks

from accounting

and attached

appropriate

documentation

and mailed.

Transcribed

recorded

claimant's

statements.

Tracked and billed

all insured

deductibles after

payments made.

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.

Risk

Management

Assistant

May 1990 to July

1993

Texas Hospital

Insurance

Exchange/ Texas

Hospital

Association –

Austin, Texas

Supported

Director of Risk

Management and

two Risk

Management

Advisers.

Transcribed all

correspondence

and reports for

department.

Scheduled travel

for department.

Assisted in developing Risk Management Survey that was sent to all insureds prior to Advisers visits. This

was used in determining "risks" for potential claims/suits.

Assisted in organizing Risk Management Seminars for insureds where continuing education credits were

awarded. Responsible for marketing seminars and registration.

Office Administration /Receptionist

May 1984 to September 1989

William Keiley, MD – Round Rock, Texas

Responsible for scheduling patient office visits and scheduled surgeries.

Pre-certified surgery with insurance companies

Located, checked in and pulled medical records for appointments. Filed

patient test results and dictated physician reports in patient files.

Processed accounts receivable and accounts payable. Made daily deposits.

Filed insurance forms for procedures performed.

Copied physician-dictated reports and complied with patient requests for copies of patient records.

Managed incoming phone calls to office and gave information to physician and nurse.

Insurance Supervisor/ Admitting Clerk

September 1976 to May 1984

Bailey Square Surgical Center – Austin, TX

Preregistered patients over telephone and in person.

Responsible for verifying insurance and determining co-payments.

Reviewed and explained insurance plans to patients to guarantee full understanding of payment policies and

procedures.

Typed patient admitting records from preregistration information. Assembled chart and attached lab reports, x-

rays and physician instructions prior to day of surgery.

Day of surgery admitted patients.

Typing and filing of insurance forms for payment.

Trained new employees on registration, admitting and billing procedures.

Follow-up with insurance companies regarding payments and denied claims.

Education

San Antonio Commercial College 1977

San Antonio, Texas

Secretarial/ Keypunch

Harlandale High School 1967

San Antonio, Texas

Member of Drill Team

Member of Future Teachers of America

Keywords

I am looking for a position where I can use my experience in the insurance and medical field.

I have long term experience supporting the claim department using Microsoft Word for creating

correspondence and report transcription. I have used Excel in creating reports for tracking claim numbers and

other reports requested by management.

I have experience in using and help in testing and customizing two different insurance data systems for 5

different lines of insurance. Also, in testing and using two different document scanning systems.

I am very familiar with reporting information to appropriate agencies regarding insurance claims such as

Medicare, Medicaid, National Practitioners Data Bank, Texas Dept. of Insurance and State Board of

Medical Examiners.

I have a vast amount of experience in customer service with heavy contact of attorneys, claimants, insureds,

and other insurance companies. In working for a physician's office and an Ambulatory Surgical Center, I have

experience in working with patients, physicians and insurance companies.

I am familiar with insurance and medical coding due to my experience in filing claims for payment working for

the physician and surgical center and also in working with Worker's Compensation claims.

I have always been recognized for my ability to multi-task and prioritize the work load. Having worked for

multiple staff at all times and being able to always meet multiple deadlines has always been a personal goal of

mine.



Contact this candidate