Insurance Medical

DEBORAH GORMAN

**** ******* **. *** *, St. Louis, Missouri, 63109 314-***-**** ***********@*****.*** WORK EXPERIENCE

HERE TODAY (EXPLANATION UPON INTERVIEW), SHREWSBURY, MISSOURI HEAD CASHIER AUG 2016 - PRESENT

Receive payment by cash, check, credit cards, vouchers, or automatic debits. Issue receipts, refunds, credits, or change due to customers. Assist customers by providing information and resolving their complaints. Establish or identify prices of goods, services or admission, and tabulate bills using calculators, cash registers, or optical price scanners.

Greet customers entering establishments.

Answer customers' questions, and provide information on procedures or policies. Process merchandise returns and exchanges.

Stock shelves, and mark prices on shelves and items. Count money in cash drawers at the beginning of shifts to ensure that amounts are correct and that there is adequate change.

Calculate total payments received during a time period, and reconcile this with total sales. Monitor checkout stations to ensure that they have adequate cash available and that they are staffed appropriately. Supervise others and provide on-the-job training.

VOORHEES & ASSOCIATES PSYCHOLOGY AND PSYCHIATRY, LLC, CREVE COEUR, MISSOURI ASSISTANT OFFICE MANAGER AUG 2013 - JUL 2016

Post insurance and patient payments using medical claim billing software Perform various collection actions including contacting patients by phone Submit clean insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS- 1500 form

Follow up with the insurance company on unpaid or rejected claims Resolve issue and re-submit claims

Worked A/R

Schedules patient appointments

Confirms future patient visits

Collect co-pay at time of service

Pulled charts for the following business day

Confirms future patient visits

Opens office mail and distributes to appropriate person Verifies and updates patient demographics

Assists front desk for breaks, lunches, and absences PREVENTION FIRST INTERNAL MEDICINE, LLC, CREVE COEUR, MISSOURI MEDICAL BILLING SPECIALIST MAR 2011 - JUL 2013

Post insurance and patient payments using medical claim billing software Prepare and submit secondary claims

Respond to inquiries from insurance companies

Review patient's account to ensure accuracy Identify and resolved patient billing complaints Perform various collection actions including contacting patients by phone Follow up with the insurance company on unpaid or rejected claims Schedules patient appointments (by phone and check-out) Verifies updates patient demographics

Confirms future patient visits

Pulled charts for the following business day

Performed EKG's, Vitals, and Specimen Collection

Resolve issue and re-submit claims

Submit clean insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS- 1500

Worked A/R

Collect co-pay at time of service

OBSTETRICS & GYNECOLOGY, ST. LOUIS, MISSOURI

PAYMENT POSTER AND BILLING SERVICE COORDINATOR JUN 2008 - MAR 2011 Ensure claim information is complete and accurate. Collect necessary information to accompany appeal

Extensive knowledge of claims reimbursement and collection efforts for Managed Care, Medicare, Medicaid, Workers Comp, and Commercial plans

Acts as a back-up to the medical secretary and back-up to Check-In. Obtains, verifies and documents patient’s insurance coverage and benefits. Schedules patient procedures and surgeries

Post insurance and patient payments

Follow up with the insurance company on unpaid or rejected claims Prepare and maintain required records and files

Determine coverage for physician office visits, diagnostic testing and surgical procedures Resolve issue and re-submit claims

Worked A/R

MID-COUNTY ORTHOPEDISTS, ST. LOUIS, MISSOURI

INSURANCE ACCOUNT REPRESENTATIVE FEB 2005 - JUN 2008 Manual process or through electronic remittance process claims in EPICPost insurance and patient payments using medical claim billing software

Evaluate patient financial status and establishes budget payment plans Verify patient benefits eligibility and coverage Call insurance company and verify patients benefits Updates patient demographic Prepare and submit secondary claims upon payment by primary insurer Respond to patient inquiries Researching and resolving unpaid balances and credit balances Submit clean insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS- 1500 form

EDUCATION

MISSOURI COLLEGE, ST. LOUIS, MISSOURI

ASSOCIATES IN BUSINESS AND ADMINISTRATION, FEB 2005 ST. LOUIS COMMUNITY COLLEGE, ST. LOUIS, MISSOURI

BACHELORS IN BUSINESS CANDIDATE, EXPECTED GRADUATION, AUG 2020 ADDITIONAL SKILLS

Detail oriented

Demonstrated service and success in teamwork

Proficiency with Microsoft Word and Excel, Lytec, Medical Manager, QuickBooks, and other medical software Extensive knowledge of billing, collections and reimbursement of claims processing Superb organizational and time management skills

Ability to thrive in a fast paced and demanding work environment Display a positive, cooperative, self-motivated, courteous, and professional attitude Excellent communication skills

Comfortable communicating via phone

Extensive knowledge of claims reimbursement and collection efforts for Managed Care, Medicare, Medicaid, Workers Comp, and Commercial plans

Knowledge of medical terminology and basic medical coding Experience in EMR, Epic, NEXTGEN, and medisoft

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