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Customer Service Insurance

Lafayette, Indiana, United States
August 31, 2017

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Kelly L McCord

*** ****** *****

Lafayette, IN * 7909

Telephone: 765-***-****



McCutcheon High School, Lafayette, IN – Graduated

American Academy of Professional Coders, Indianapolis, IN

Employment History:

Solutions Specialist/Insurance Follow-up, Salud Healthcare Solutions, Lafayette, IN

August, 2011 – August, 2017

• Hospital outpatient medical billing

• Research outstanding hospital claims for non-payment

• Research incorrect payments and denials on hospital claims

• Load insurance carriers into system

• Contact patient or provider as needed

• Work a monthly work list to get outstanding claims paid or billed

• Various other clerical duties as needed

Appeals/Coding Analyst, United Health Group, Lafayette, IN

December, 1999 – August 2011

• Handled all incoming provider appeals

• Handled escalated providers

• Managed escalated issues from providers and responded by verbal or written communication

• Advised and educated providers on incorrect billing/coding issues

• Reviewed medical records

• Investigated any coding issues or benefit issues for the Claims department; or other departments in the company

• Managed Claims editing software system

• Processed high complex claims

• Backed up Claims supervisor and Claims auditor

• Provided feedback to Claims staff for improvement and changes regarding HCPC Codes, CPT codes and ICD-9

• Assisted Member Services Representatives when claims questions

• Updated HCPC codes, CPT codes and ICD-9 codes when new, deleted or changed

Member Services Representative, Arnett Health Plans, Lafayette, IN

October 1998 – December 1999

• Answered incoming phone calls

• Helped resolve member questions

• Entered new enrollments

Additional Skills:

Knowledgeable in ICD-9 codes, CPT codes and HCPC codes

Medical Terminology

Excellent Customer Service skills

Strong analytical/problem solving skills

References available upon request

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