Customer Service Insurance
Resume:
Jeanette Harris
Decatur, GA 30035
**********@***.***
Objective To obtain a challenging and rewarding position that will utilize my
skills and background in the Medical & Insurance Industry.
Qualificatio Medical Terminology, Medicare & Medicaid Billing, Commercial Billing
ns Claims Examiner Medical Collections, Payment Posting, Customer
Service, HCPC, ICD9, IPDR, CPT-4 CODING.
2010-2012 Emory Healthcare Inc.
Patient Account Rep-Electronic Billing for
Medicare,Medicaid,Commerical and Managed care payers, work rejected
folder, research claims that denied in billing system, verifies
insurance Identifies and resolves patient billing complaints.
Prepares, reviews and send patient statements
Evaluates patient's financial status and establishes budget payment
plans. Follows and reports status of delinquent accounts.
2007-2009
Administrative Services Inc. Tucker Ga
Customer Service Specialist- Provided assistance to Union Members on
medical claims. Responsible for ensuring all benefit eligibility
questions were answered promptly & timely. Handled inbound call
volume of 55-60 inquires daily. Ensured members received high level
2004-2007 of customer care. Responsible for training & leading new personnel on
customer service inbound system.
Neurology and Headache Specialists of Atlanta, GA
2002-2004 Billing Specialist/Payment Poster- Responsible for entering patient
demographics. Verified insurance eligibility for patients. Medicare
and Medicaid billing and commercial billing, Posted patient charges &
prepared bank deposits. Responsible for collecting timely payments &
prompt billing Obtained referrals from patients & Primary Care
2001-2002 Physician when needed.
Front Office Specialist - Scheduled appointments for team of 6
physicians. Answer incoming physician's line and direct calls to the
appropriate location/person. Mail out new patient information for
completion. Fax new patient information. Generate Fee Slip exception
2000-2001 reports. (Must be reviewed daily to account for all fee slips
generated that day.) Fill in at check in window, verify patient
address insurance information, provide revisit forms to complete and
collect co-pays.
Canada Life Assurance Company Atlanta, GA
Dental Specialist - Review and processed claims according to policy
guidelines.
Maintained provider files. Responded to customer service referrals
and assisted the policyholder provider with claimant inquires
utilizing dental codes such as CDT's etc. Completed adjudication of
electronic claims. Maintained patient files.
Patient Account Services of Atlanta Norcross, GA (Temporary
Assignment)
Collections Specialists - Monitoring insurance claims by running
appropriate reports and contacting insurance companies to resolve
claims that are not paid in a timely manner.
Identifies coding or billing problems from explanation of benefits
(Eobs) and work to correct the errors in a timely manner. Identify
problem accounts and escalates appropriately. Updating patient
account records to identify actions taken on the account. Work with
patients and guarantors to secure payment on outstanding account
balances. Responsible for sorting and filing correspondences.
1999-2000 Healthcare Financial Staffing, Norcross, GA
Emory Eastside Medical Center, Snellville, GA (Temporary Assignment)
Medical Billing Processor - Verified insurance eligibility, matched
corresponding bills with insurer's insurance carrier, keyed
claim-processing status, reconcile charges for each claim after
verification. Communicated with insurance carriers to resolve
billing/insurance carrier discrepancies.
1998-1999 International Insurance Personnel Inc. Atlanta, GA
Blue Cross Blue Shield of Georgia (Temporary Assignment)
Claims Examiner - Reviewed medical / surgical claims, provider /
subscriber claims, interpreted claim histories. Researched and
resolved claim discrepancies. Responsible for posting insurance and
Medicare payments, processed medical claims for payment or rejection
finalized claims for payment resolution.
1988-1998 Blue Cross Blue Shield of Connecticut, North Haven, CT
Claims Examiner - Reviewed medical / surgical, provider/subscriber
claims, interpreted claim histories, analyzed claims, assigned HCPC,
ICD9, IPDR, CPT-4 procedure codes to claims. Responsible for
entering fees into computer claims system for payment or rejection,
interpreted membership contracts, set-up dental claims. Determined
eligibility for payment by applying appropriate contract provisions.
1992-1994 Data Entry Clerk - Reviewed subscriber claims for accuracy, entered
on-line alpha and numeric information for proper claim adjudication,
and researched subscriber membership and contracts.
1988 - 1992 Claims Clerk - Processed claims for providers and subscribers,
maintained status of membership, verified group insurance
information. Responsible for processing claim payments maintained
customer relationship with client and subscriber regarding claim
payment issues and discrepancies.
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