Insurance Manager

Blenda Brooks

**** ******** ***** *********** **, 60525 Phone: ( 708)

***-****

Qualification Summary:

Within the Healthcare industry, I’ve established and maintained long-term, patient and insurance

relationships, building trust and respect by consistently meeting and exceeding expectations. I’m able to

communicate clearly and concisely, verbally and in writing. Highly organized, detailed oriented excellent

communication skills, supportive team player, committed and responsible proven interpersonal, team-

building, motivational abilities, reliable and adaptable. Learn new processes quickly and take initiative

work effectively with other employees. Healthcare applications such as: NextGen, Misys, Banner, Medic

Plus, NEBO, E-care, Allegra, Vision, Florida Shared, Medsys and MS Office.

Professional Experience:

09/2006 – 12/2012 Sinai Health System- Phoenix Physician Services

Third Party Physician Biller

• Review Insurance EOB’s and initiates appeals as necessary.

• Print and mail UB92s or HCFA 1500s as necessary for account resolution.

• Act cooperatively and responsibly with patients, visitors, co-workers, management and clients.

• Responsible for maximum productivity in the recovery of delinquent accounts receivable.

• Documents all collection activity; maintains and organizes unit and responds to all

correspondence, communication and/or verbal inquiries from all relevant parties.

• Follow up on all claims from billing through final resolution.

• Review and prepare claims for manual and/or electronic billing submission.

• Correct and identify billing errors and resubmit claims to insurance carriers.

• Follow up on payment errors, low reimbursement, denials, etc.

• Records and maintains complete and accurate documentation of all activity performed on

appropriate medium.

• Applied all company policies and procedures, as well as local, state and federal regulations,

relevant to their area of operation.

09/2002 – 12/2006 Sinai Health System- Phoenix Physician Services

Collection Specialist

• Conducted appropriate account activity on final billed claims by contacting

government/commercial insurance agencies.

• Requests additional information from patients, medical records, and others upon request from

payors.

• Review contracts and identify billing or coding issues and request re-bills, secondary billing, or

corrected bills as needed.

• Updates plan IDs and patient/payor demographic information; posts notes and memos to

accounts; identify payor issues and trends; and solve recoup issues.

• Returns accounts to Appeal Writers for next level appeals as needed.

• Identifies payor trends in payment delays and escalates issues to Supervisor.

• Assists with special projects by utilizing excel spreadsheets

• Assists patients with questions regarding their accounts and determines the needs of the patient.

• Researches patient concerns and follows-up with patients/insurance companies regarding the final

status of patient account.

• Works with Site Manager or Specialist to resolve patient issues.

• Responds to patient /insurance requests by mail and handled denied claims for payment.

References Available Upon Request

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