Insurance Microsoft Office

DONNA SEMRO

**** ********* ****, ********* ****, IL 61115 779-***-****

Email ************@*****.***

Seasoned and highly competent billing specialist seeking a position that will allow me to use my skills and past experiences. Exceptional analytical, problem-solving, and organizational skills. Working knowledge of HFS Medicaid/non-Medicaid billing, electronic medical records EPT coding, and insurance reimbursement.

EXPERIENCE

JUNE 2016 – FEBRUARY 2018

INSURANCE AND BILLING COORDINTOR, CIRCLE OF WELLNESS

Credentialed physicians to evaluate the qualifications and practice history of a doctor. Included a review of a doctor's education, training, residency and licenses. It also included any certifications.

Researched and processed claims according the processing guidelines and benefits

EPT coding

Coordinated with patients, physicians and staff members to develop schedule

Assisted insurance providers for the purpose of verifying eligibility of insurance claims and processing claims

NOVEMBER 2014 – JUNE 2016

CLAIMS EXAMINER- MOLINA HEALTH INSURANCE - MEDICAID, FIRSTSOURCE

Identified and resolved potential billing errors

Relied on by management to assist with claims processing due to my speed and attention to detail

SEPTEMBER 2014 – NOVEMBER 2014

PURCHASING AGENT – ACCOUNTS PAYABLE, NATIONAL EXPRESS CORPORATION

Matched Purchase Orders with Invoices to insure prompt payment to vendors

Generated requisitions through Oracle

Generated Purchase Orders through Oracle

Backup duties included switchboard operations and other administrative responsibilities

JANUARY 2009 – OCTOBER 2013

ACCOUNTS RECEIVABLE – BILLING SPECIALIST, THE LARKIN CENTER

Submitted HFS Medicaid/non-Medicaid billing; reconciled rejections, and served as an Administrator for billing system

Assisted the Accounting department with financial reports/accounts payable/accounts receivable

Setup and maintained records for all clients, switchboard operations, company vehicle logs, and incoming/outgoing mail

Posted transactions into a general ledger

Prepared internal reports for receivables including reconciliation statements, aging reports, unpaid order detail, credit memo statements, suspense account statements, 1400 general ledger account and cash clearing house account

EDUCATION

HIGH SCHOOL DIPLOMA, STREAMWOOD HIGH SCHOOL

Ranked 3rd out of 530 students – graduated with high honors

SKILLS

Medical terminology

Insurance terminology

Data entry

Data management

Fundware

Electronic health records

Microsoft Office systems (Word, Excel, Office)

Medical billing and coding software

Medicare, Medicaid, and private insurance claims

Oracle

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