Customer Service Insurance
Resume:
Jerviece Manning
*** ******* *****, *******, ** *9209
********@*****.***
Objective A clerical position in a fast paced environment.
Excellent Organizational Skills Telephone Answering
• •
Skills
1. 1.
Strong Customer Service Skills Word Processing and Typing 45 WPM
2. 2.
Computer Proficiency Clerical Skills
3. 3.
Data Entry Insurance verification
4. 4.
Medicare Secondary Recovery Filing
5. 5.
Ability to multi task Experience working in healthcare facility
1. Computer: WordPerfect, Microsoft Word, Microsoft Excel, etc (various Microsoft programs)
2. Ability to analyze problems and solve problems
3. Experience with CMS systems: ECRS, HIGLAS, RSC, REMAS, CWF/HIMR, IMAGIO
2011 Present
Experience Case Analyst
A. Cahaba, Government Benefit Administrators, Ridgeland, MS
Responds to both telephone and written inquiries from beneficiaries, attorneys, other Medicare contractors,
and insurance companies on a daily basis, as well as internal phone calls and emails. Research claims data
and applicable guidelines, makes refund requests, and provide information to those making inquiries regarding
secondary payer liability and action to be taken. Reviews and responds to requests for
reconsiderations/appeals. Responsible for identifying mistaken Medicare primary payments and initiate
recovery process within REMAS and issues conditional payment listings. Compose letters notifying proper
parties of case status. Supports the MSPRC by determining Medicare’s responsibility for claims involving
other parties, such as Worker’s Compensation, the Working Aged, Auto/Liability/No Fault. Responsible for
ensuring payments and adjustments of claims have occurred within MSP laws, and initiates recovery of
mistaken payments in accordance with the laws established for each category. Maintains knowledge of liability
and no fault laws to determine the appropriate level of Medicare reimbursement, whether primary or
secondary. Performs follow up duties as prescribed by Medicare requirements. Follows up periodically and
again at timely intervals when Medicare makes conditional payment. Work in a team environment and assist
other team members as needed. Adheres to qualitative and quantitative standards as established to meet
contractual obligations and changing business requirements.
Accomplishments:
4.Recover money for Medicare
5.Received monetary bonus for reaching goal for Cahaba’s Incentive
Plan
6. 100% Efficiency
7. Experience and knowledge of both pre and post demand
encounters
8. Experience and knowledge of HIGLAS
B. Chickasaw Nation Industries, Ridgeland, MS
Responds to both telephone and written inquiries from beneficiaries, attorneys, other Medicare
contractors, and insurance companies on a daily basis, as well as internal phone calls and
emails. Research claims data and applicable guidelines, make refund requests, and provide
information to those making inquiries regarding secondary payer liability and action to be
taken. Reviews and responds to requests for reconsiderations/appeals. Responsible for
identifying mistaken Medicare primary payments and initiate recovery process within REMAS
and issues conditional payment listings.
Accomplishments:
9. Recover money for Medicare
10. Top Performer for June 2011
C. Staffers Temp Service, Jackson, MS
Review open and closed communications/correspondence from insurance companies,
attorneys, and beneficiaries that have been assigned to me. Verify if authorizations were valid
or invalid. Reach goal for the number of closures required per day.
Accomplishments:
11. Hired with Chickasaw Nation Industries as a Permanent Employee
12. Recover Money for Medicare
Central Scheduler, Admissions Receptionist/Registrar, and 2004 2010
Central Scheduler
A. Bolivar Medical Center, Cleveland, MS
Central Scheduler Schedule and maintain a record of surgeries for doctor’s offices through
Microsoft Excel. Schedule x ray procedure for doctor’s offices through HMS monitor
graphical view system. Pre register patients. Verify insurance through passport, access blue, or
by calling the insurance company. Verify co pays, deductibles, and co insurances. Collect
upfront collections towards co pays, deductibles, and co insurances. Sort and file doctor orders
by date and also by alphabet
Admissions Receptionist/Registrar Customer service/Assist patients accounts. Answer and
direct incoming calls. Verify insurance. Collect upfront collections. Register patients. Comply
with emergency and safety activities by responding to codes. Admit/Register/Discharge
patients
ER Register Enter patients into pro med. Admit/register/discharge patients. Answer and
direct incoming calls. Verify insurance. Collect co pays.
2000 2003
Education Elementary Education (No Degree Obtained)
Delta State University, Cleveland, MS
Diploma 2000
Lakeside High School, Lake Village, AR
Honor Graduate
Furnished on request.
References
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