Customer Service Insurance

Ashley Sims

***** ******* **, ****** ** *****

720-***-**** ****************@*****.***

Objective

To obtain a position as a medical coder, appealer, and or biller, where I can utilize the skills I have developed to contribute to the increasing success of an organization

Summary of Qualifications

Over 11 years of appealing and following up on claim denials

4 yrs experience working remote

Familiar with CPT and ICD-10 standards

Verify updates with coding and insurance regulations monthly

Professional, organized and detail oriented individual committed to excellence

Ability to build relationships with customers and provide exceptional customer service

Ability to adapt well to new environments; quick to learn new techniques, skills and computer applications

Reliable, dedicated, and focused; able to multitask and complete goals in a timely manner

Friendly and self motivated

Strong computer skills include Microsoft Word, Outlook, Internet Explorer, Excel and EPIC

Professional History

NAVIGANT

CPC coder, claim edit reviewer-2013 to current

Over 9 years in Family and Pediatric cpt and diagnosis coding with

5 years of outpatient and inpatient charges especially for newborn rounding

3 years of ortho/radiology/injection coding

2.5 years of er and urgent care coding

Review and verify claims are correct with CPC and ICD 10 codes that are being utilized

Verify providers billing, through audits, match documentation and chart notes with chosen CPT and diagnosis codes

Code inpatient, newborn and delivery charges

Appeal claims and investigate reasoning insurance companies deny out

Verify patient insurance

Verify claim edits in epic before charges go out through Navicure

Call insurance companies to work outstanding denial claims, and work appeals to maintain payment

Currently studying for orthopedic surgery billing

Work ER and urgent care coding along with radiology, pediatric, family and internal med clinics

Maintain and update monthly new updates through CPC and Insurance guidelines

3 months in residence coding and denials

Cherry Creek Pediatrics, Denver, CO

Medical Billing Specialist – 2008 to current

Process claims and verify that charges were billed correctly

Bill out charges to multiple insurance companies.

Post and appeal payments received

Follow up with patients regarding balances with phone calls and letters

Process and bill newborn hospital charges

Front Desk Coordinator – 2006 to 2008

Greet high volume of incoming patients and parents

Check balances and collected co-pays and balances

Verify present insurance

Answer multiple incoming calls

Conduct prenatal tours with potential patients, and answered questions regarding our care and our facility.

Schedule appointments

DTC Eye Associates, Greenwood Village, CO

Medical Technician/ Patient Counselor – 2005 – 2006

Brought patients back for eye exams and completed scans (corneal

Topography and wave front analysis)

Worked on various data projects to assist with marketing

Worked one on one and established relationships with patients on a day to day basis

As a counselor I promoted our high end technology to potential patients

Assisted with study charts

Filled in for the receptionists- answered incoming calls, posted patient

charts, filed, and scheduled appointments

Worked as an assistant to get patients ready for surgery

American National Bank, Denver, CO

Internet Banking Specialist - 2005 - 2005

Coordinated and set up clients and businesses for internet banking

Organized and filed data while maintaining quick access to important information

Answered incoming calls; spoke with customers on a day to day basis

Handled customer enrollments and portfolios with great detail

Updated and maintained customer accounts regularly

Teller 1 - 2003 - 2005

Handled bank transactions with customers on a regular basis

Balanced and compared various deposits to verify match potential

Excelled in a varying environment

Provided excellent customer service while answering phones

Education

College

University of Colorado at Denver, August 2001 to June 2004

High School

Mullen High School, Graduated May 2001

References available upon request

Contact this candidate