Customer Service Insurance
Resume:
Kelly L McCord
Lafayette, IN * 7909
Telephone: 765-***-****
E-Mail: **********@*****.***
Education:
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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