Customer Service Insurance

Michelle M. Mosley

*** ***** ****** *****

Stockbridge, GA 30281

Phone: 334-***-****

Cell: 334-***-****

E-mail: acc6aw@r.postjobfree.com

HIGHLIGHTS

. Excellent verbal communicator * Customer service oriented

. Self directed * Enthusiastic

team player

. Problem solving * Quality leadership

. Deadline driven * Dedicated worker

*Worked in Healthcare field since 1991

EXPERIENCE

July 2010 to Current Baptist Health

Montgomery, AL

Job Title Refund

Representative

. Responsible for researching and resolving credit balances on a daily

basis.

. Determine the source of the credit balance by examining supporting

documentation

. Transfer patient credit balances to other outstanding accounts

. Identify posting corrections. Complete posting correction form and

submit to the posting department for review and necessary actions to

resolve credit.

. Issue refund s to insurance companies and patients/guarantors

. Have knowledge of Medicare and Medicaid refund regulations

. Have knowledge of Baptist Health's Managed Care contracts so that

credits are correctly identified and, if appropriate the correct

amount is refunded or contractually adjusted in compliance with each

parties' regulations

. Compose refunds letters to insurance companies, guarantor and/or

patients

. Work incoming refund requests from various insurance companies and

respond accordingly

February 2005 to June 2011 Lab Corporation of America

Montgomery, AL

36104

Job Title Accessioner - Lab Assistant

. Receive doctor's orders that include patient information and test to

be ordered along with specimens such as urine, blood, etc...

. Input information in system

. System assigns a number and print labels to go on the doctors orders

and all specimen(s)

. Specimens are sorted and spun down if required.

. Must know your tube types such as red top, green top, purple top, SST,

etc... in order to properly label specimen(s) correctly

. Must know what specimens need to be spun down and which ones you can

not spin down

. Pack specimens twice a day to be shipped to Birmingham

. Label boxes accordingly.

. Able to handle multi line phones

June 2004 to December 2009 Rehab Associates

Montgomery, AL 36109

Job Title Patient Account Representative

. Status physical therapy claims for the Georgia clinics

. Contact various insurance companies and/or patients in regards to

outstanding claims/balances

. Document each account accordingly

. Prepare letters to patients for various reasons such as:

1. No insurance coverage

2. Failure to keep promise to pay

3. No payment

. Prepare appeal letters to insurance companies when necessary

. Submit refund request

. Submit posting correction

. Do check research request for outstanding/missing payments

. File claims to secondary insurance

. If insurance information is incorrect, input correct insurance

information in system and re-file claim

EDUCATION

Frank W. Ballou Senior High School

Washington, DC

GRADUATED: 1972

Business Courses

High School Diploma

Contact this candidate