Insurance Medical

Dawn M. Powers

Windham, ME ***** 207-***-**** ************@*****.***

Qualifications:

Strong history of submitting error free medical and insurance claims.

Proficient use of communication skills, building harmonious relationships with patients, venders, coworkers, and management.

Well versed in HIPPA laws, rules and regulations.

Employment:

Mercy Hospital Portland, Maine June 2014 – March 2017

Reimbursement Technician

Worked cooperatively with patients, insurance company, hospitals and doctors processing insurance bills properly.

Processed 50 patient accounts daily reviewing documents, edits and finalized documentation for redetermination of commercial, state, federal and third party insurance billing on the following systems: Ability, Allscrips, Craneware, Meditech, National Government Services and Connex, Relay Assurance Plus, Siemens Gold and Soarian Stockamp.

Reviewed Evidence of Benefits for all denials of payment and inappropriate payments to the hospital, processed the appeals for the patient to the insurance companies and resubmitted insurance claims to the appropriate insurer for the patients.

Worked and followed all the HIPPA laws, rules and regulations when processing all patient billing.

Dr. Steven Shaw Portland, Maine May 2012 – April 2014

Front End Manager

Billed insurance companies for the patients’ procedures from the medical records received from the hygienist, and dentist.

Scanned medical records, x-rays, and insurance information for three hundred patients using the Paterson Dental Billing System.

Accountable for processing, ordering, and payment of dental supplies and special orders for the dentist and hygienist.

Distributed and administered the HIPPA rules, regulation and laws for nine staff members.

UNUM Insurance Company Portland, Maine October 1997 – November 2010

Intake Specialist

Managed 50 special unit accounts and short term disability claims, working closely with the claims payers, account managers, and the department management to help the patient process their disability claim.

Communicated with the employee, doctors, employer, and insurance companies to request missing information and documentation that was need by the claims representative to complete the process to pay the employees disability claim.

Created excel spread sheets for Insurance Rating Discounts for companies and employees options.

A member of the UNUM Safety, First Responder and OSHA Team for ten years.

Education:

Andover College Portland, Maine August 1983 – May 1985

Associate Degree, Secretarial and Office Administration

Andover College Portland, Maine August 1985 – May 1987 Associates Degree, Accounting

Portland Adult Education Portland, Maine January 2011 – April 2012 Accounting, Medical, Office Administration Assistant

and Microsoft Office 2010 Certificates

Volunteer Student Accounting and Computer Tutor

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