Customer Service Insurance
Resume:
Mary Saxon
Wichita, KS *****
EMPLOYMENT
July 2010 to Present Billing Clerk- Plastic Surgery Center
Enter charges, Submit claims electronically and by paper, post payments,
work denied claims, answer patient account questions, set up payment plans.
Daily balancing of charges and payments. Obtaining predetermination and/or
precertification for surgical procedures.
June 2010 to Present Patient Account Rep- Kansas Surgery and Recovery
Responsible for working self pay accounts, setting up payment plans, take
credit card payments, turn past due accounts to collections, make
adjustments or write-offs when needed, provide back up for insurance
verification clerk. Compose follow-up and customer service letters.
10-07 to 12-08 Member Service Representative - Preferred Health Systems
Provided members and providers with support in all areas of covered
benefits, eligibility, plan administration. Trouble shoot claims (medical
or prescription) for the member and reprocess when necessary. Communicate
with all contacts in a constructive, courteous, respectful, helpful and
timely manner.
9-06 to 1-07 Patient Account Rep/Billing Clerk- Kansas Medical Center
Application and credentialing insurance companies. Negotiate with non-
contracting insurance companies for payment on individual claims. Composed
a facility specific letter to patients explaining the process for payment
and/or adjustments since facility is out-of- network. Claim submission and
follow-up. Daily contact with patients with questions on accounts. Advise
patients of payment options and set up payment plans and various
responsibilities that arise in a brand new facility.
3-05 to 8-06 Patient Account Rep/Billing Clerk -Galichia Heart Hospital
Electronic and paper claim billing, follow-up, and appealing claims for non-
contracting insurance. Educated patients on policy and benefits. Advise
patients of payments options: financial assistance and/or set-up payment
arrangements for time pay. Daily contact with patients and insurance
companies. Responsible for working credit balance accounts: adjust and/or
refund. Assist in negotiating proposals received from networks for payment
on claims.
6-04 to 3-05 Billing and Coding Clerk - Raghavan Clinic
Responsible for coding diagnoses and procedures using ICD-9 and CPT. Enter
office, lab or professional hospital charges. Post payments from insurance
and patients to accounts. Weekly billing to insurance companies and mail
out patient monthly statements. Work with patients in setting up payment
arrangements on accounts. Back up to receptionist and scheduling of
appointment
6-02 to 6-04 Precertification/Referral Specialist- Midwest Surgical, P.A.
Verified eligibility and benefits. Precertify and/or obtain referrals for
procedures. Code diagnoses and procedures using ICD-9 and CPT. Entered
charges for procedures. Electronic claim submission. Research claims and
when needed appeal. Posting payments to accounts. Set up payment plans and
responsible turning delinquent accounts to collection agency.
EDUCATION
Wichita Area College- Medical Secretary Certificate
West High School- High School Diploma
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