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Manager Insurance

Location:
Tallahassee, Florida, United States
Posted:
August 28, 2018

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Resume:

Laurie Ann McGough

P.O. BOX ****

Tallahassee, FL 32317

Phone 850-***-****

Objective: To obtain a full-time position in a challenging environment that will allow opportunities for professional growth.

Experience: Tallahassee Outpatient Surgery Center Tallahassee, FL

Coder/Biller

03/08/2005 to Present

Code Operative Notes for Orthopedic, Pain and Eyes for Surgery Center

Bill to all Insurance companies for the entire facility.

Accounts Receivable - post all incoming payments from patients and Insurance Companies

Process all payroll for the facility via Kronos.

Process refunds to patients and Insurance Companies

Cover Business Office Manager while out of the office

Health Plan Southeast Tallahassee, FL

Claims Supervisor

09/1997 to 06/2003

Worked directly with the Vice President of Claims to ensure the Call Center and Claims ran smoothly on a day to day basis.

Ensure the smooth flow of claims in and out of the department to ensure a quick turnaround of accurate claims entry for manual and electronic claims.

Responsible for making sure the Call Center is receiving calls and the Provider’s issues are being resolved in a timely manner.

Develop telephone call center reports

Process voids, refunds and take backs

Compiles a daily excel spreadsheet of voids, refunds and take backs with formulas for the Finance Department

Perform semi-annual performance reviews and maintenance of the Department’s Procedural Manual.

Trained subordinate staff

Claims Examiner

06/1992 to 09/1997

Performed third party information coordination and claims processing, including oral communications as well as claims preparation and entry.

Handled COB claims processing including requests by third parties for copies of records

Acted as the problem solver for providers and Doctor’s and member issues over the phone

Reviewed and processed refunds for accuracy and request refunds as appropriate

Acted as the problem solver for member inquiries

Data Entry Operator

08/1988 to 06/1992

Processed hospital claims for Tallahassee and Panama City Region

Prepared denial letters for members

Adjusted hospital claims

Received provider inquiry calls

University Insurance Tallahassee, FL

Secretary

10/1986 to 11/1987

Prepared written policies on automobiles, mobile homes and motorcycles

Answered all incoming phone calls

Department of Environmental Regulation Tallahassee, FL

Data Processor

04/1986 to 10/1986

Reviewed Centel credit card bills for payment

Reconciled all vouchers being transmitted for payment or receipts

Entered data/information into the company database

Printed vouchers, audited, filed and input into SAMAS

EDUCATION:

Johnson County Community College

Lenexa, KS

Fashion Merchandising, Personal Finance

Shawnee Mission Northwest General Studies

Shawnee, KS

Typing, Business, Personal Finance and Computers

HARDWARE AND SOFTWARE

IBM, As400, Samas, Microsoft Word, Lotus 123 and Excel, Macess, 10 key, Kronos, ZirMed.

REFERENCES AVAILABLE UPON REQUEST



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