Customer Service High School
Resume:
Mary Irvine
Delaware, Ohio *****
********@********.**.***
The insurance industry is a growing and ever changing field that needs experienced
people to get the job done in a correct and timely manner. The claims process can be
complicated, but the skills that I bring to your company will make the procedure run as
smooth as possible, to keep customers satisfied, providers happy, and the company at
or below budget.
The many skills that I posses will be an advantage to your company in order to
accomplish the workload in a correct and timely fashion. Some basic skills are as
follows:
Excellent Work Ethic
Dependable
Hard Working
Reliable
Excellent File Skills
Computer Knowledge
Microsoft Office
Excellent Oral Communication Skills
Excellent Written Communication Skills
Excellent Phone Skills
Mentoring
Customer Service
As my resume shows, the more specific job related skills and certifications are
numerous and will be an asset to your company.
I look forward to talking with you face to face, or on the telephone for the interview
process to begin and answer any and all questions you have and discuss the wonderful
future ahead accomplishing a common goal together. Please contact me through email,
Mary Irvine
2263 Ford Rd.
Delaware, Ohio 43015
********@********.**.***
phone, or mail correspondence. I will be in touch by the end of the week to discuss
when we can have the opportunity for all questions to be addressed.
Objective:
The challenging world of insurance needs dedicated and experienced people to get
things done in an efficient, cost effective, and timely manner. The experience I bring will
be a valuable asset to your company. I bring skills and ability to get things accomplished
in a proper fashion to keep customers satisfied and keep the company within or below
budget.
Technical Skills/ Proficiencies:
POS Cash Control (stop pay, voids,
and refunds)
HMO
Auditing
PPO
Training for adjustments, claims
Medicare
EMC
Medicaid
Managed care claims
HIPPA
DME claims
Moving from conflict to
collaboration DRG pricing
VA(veterans claims) processing Provider inquiry calls
Adjustments Membership eligibility
Mary Irvine
2263 Ford Rd.
Delaware, Ohio 43015
********@********.**.***
Training/ Certificates:
Time Management Managed care
Geno Tables ICD 9
Microsoft Word CPT
EFDE Human Anatomy Course
HIPPA ITS Blue Card Host
New implementation for the High Dollar claims (over
Toyota Account $100,000) special processing
EEC Customer Service
Auditing of claims
Mary Irvine
2263 Ford Rd.
Delaware, Ohio 43015
********@********.**.***
Built claims in Model Office
through EFDF or downloading
Experience: claims from production
01/1987-01/2007 Anthem Blue Cross Microsoft Excel for Validation
tracking
Blue Shield- Senior Claims Processor
Forwarded completed claims to
other members for training
Processe Assisted
Claim Payment tables validation
d claims GM audit
for providers
by both team
FDE and
Education:
Worked
EEC
directly
Franklin Heights High School
Team with VA
Coordinat administr
Columbus, Ohio
or for ation
1960-1964
EMC
ITS Blue Graduated in 1964
claims
Card
(First
Host
pass rate Urbana College
increase Urbana Ohio
Lumping
of 65%) 1970-1974
of
revenue Degree in Business
Involved
codes to
in Toyota
meet
account
restriction
implemen
guideline
tation
s
( Model
office,
*references available upon request
Assisted Nasco Administration
analyst Conference calls, testing
of claims status reports
11/2007-5/2009 Horizon Blue Cross
Blue Shield- Business Analyst
Prior Authorization Project for
Horizon
Contact this candidate