Customer Service Medical

**** *** ***** ***** *******, TX *****

PHONE 972-***-****

CELL 469-***-****

E-MAIL *********@*****.***

Leilani E. Nance

SUMMARY:

Motivated professional who has working knowledge of all lines of medical insurance with emphasis on specialty

groups within a medical office setting. Data entry, keying 55+ wpm, ability to use all office equipment,

organized, pays attention to detail, HIPAA compliant, able to make decisions, can work independently, reconcile

problems before they escalate, ability to make production, results driven, ability to meet tight deadlines

EDUCATION:

Profession Certification Center, Inc. Desoto, TX

Computer Technician Program Graduate Aug. 27, 2009

• Business Mathematics

• Computer Basics & Keyboarding

• PowerPoint

• Access

• Excel – spreadsheets, tables, etc.

• Microsoft Word – business letters, reports, mail merge

• A+

Richland Community College Dallas, TX

Gary Job Corps Center San Marcos, TX

Judson High School Converse, TX

Graduate May 1980

WORK EXPERIENCE:

UTSW Medical Center Dallas, TX

Senior Claims Analyst Nov 1999 – Apr 2008

• Medical billing and collections for Neurological procedures and drugs for physicians

• Working knowledge of Commercial, Managed Care, Medicaid, Medicare, Workers Comp accounts

• Heavy customer service with clients while investigating, analyzing data to make determination of insurance company’s

liability before billing patients, resolving any discrepancies of nonpayment by verbal or written appeals

• Use of resources CPT, ICD-9, Medical terminology, human anatomy, internet, and software packages such as Novell,

Groupwise, Citrix, Sophos Antivirus, iAIM, entry level on Kronos

Physician Reliance Network (Texas Oncology) Dallas, TX

A/R Specialist and Indigent Coordinator Apr 1998 – Oct 1999

• Provide excellent customer service to ensure confidence for high profile clients

• Verifies account data by reviewing, correcting, deleting, or reentering data

• Maintains database by entering new and updated customer and account information

• Billing and collections for physicians, posting A/R

Blue Cross Blue Shield of Texas Richardson, TX

Senior Claims Examiner II Nov 1986 - May 1996

• A/R collected, payment posting, reimbursements, adjustments, claim adjudication

• Examined claims and medical bills

• Approved payments for medical procedures per diagnosis

• Used reference materials to approve payments: ICD-9, CPT, HCSPCS, and government manuals, McKesson

claimcheck, CCC (clear claim connection to mirror claims), iExchange for eclaims

Contact this candidate