Customer Service Insurance

Archaletta O. Ray

**** ****** ** 410-***-**** Cell

Baltimore, MD. 21244

***********@*****.***

PROFESSIONAL SUMMARY

Over seven years of Healthcare Medical coding guidelines and coding techniques with expertise in

physician coding, outpatient coding and facility coding. In addition, possess extensive experience in

CPT and ICD-9 coding and reconciling charges to referrals and other provider billings with emphasis

on Healthcare Claims processing and adjudication. Additional experience working with

Enrollment/Eligibility systems, paper claims, applying co-payments, error reporting and processing,

and providing customer service to insurance plan members.

EXPERIENCE

Medstar Health Physician Partners, Baltimore, MD August 2011 – Present

Charge Entry Representative

• Verifying/updating patient demographics and insurance information prior to billing

• Accessing the various insurance company websites and /or provider lines to verify eligibility and

plan coverage.

• Applied patient co-pay payments to associated charges and ensuring all co-pays on the receipt log

for given dates of service have been applied.

• Print and balance pre-logs and proofing charge batches prior to posting them.

Proactively fix errors before being submitted to the insurance companies including inpatient,

outpatient and office visits

Midatlantic Cardiovascular Associates, Pikesville, MD September 2005 – July

2011

Due to a merger

Office Charge Entry Specialist

• Reconciling all charges received against the various doctor’s schedules and tracking/requesting

missing work on an Excel spreadsheet which is used as a communication tool with the offices.

• Verifying/updating patient demographics and insurance information prior to billing

• Accessing the various insurance company websites and /or provider lines to verify eligibility and

plan coverage.

• Entering and linking referrals to applicable charges while tracking and requesting missing referrals

on Excel spreadsheets

• Applied patient co-pay payments to associated charges and ensuring all co-pays on the receipt log

for given dates of service have been applied.

• Print and balance pre-logs and proofing charge batches prior to posting them.

• Proactively fix errors before being submitted to the insurance companies including inpatient,

outpatient and office visits.

• Attached HCFA’s to the approiate referrals before permanent posting to the system and maintain a

batch file for those charges

Hirsch Financial Services, Inc. Hunt Valley, MD May 2003 – August

2005

Account Representative

Page 2-410-***-**** - Cell

***********@*****.***

• Manage Solution Scope and Requirements

• Process and balance different accounts for Medical and Dependent care benefits on a scheduling

basis

• Generate balance reports in the Travis system for the review by Human Resources

• Send quarterly statements for review by the participant prior to end of plan year

• Email Enrollment forms to members for open enrollment for the new plan year

• Generate checks or other payment types to be sent to the participant for reimbursement of claims

submitted for payment

Central Mississippi Medical Center, Jackson, MS August 2001 – March 2003

Department Secretary of Women Services

• Arrange schedules, coordinated meetings, appointments, and travel arrangements

• Ordered, received, and disbursed office supplies and materials as needed

• Maintained patient confidentiality in processing birth certificates

• Coordinated all incoming and outgoing mail and other correspondence for the department

• Received all incoming and processed all out going telephone calls and messages to appropriate

individuals

• Prepared a weekly calendar of meetings and activities for the Director of Women Services

Computer Science Corporation, Greenville, SC March 1996- April 1999

Senior Correspondent

• Processed new annuity contracts financial and non-financial transactions

• Performed functions on DicsIRS and Payout systems and assisted agents as needed

• Performed quality checks on all transactions processed by customer service representatives and

provided feedback to reps and to management.

• Serviced Annuity products for a third party administration

• Processed financial and non financial requests, verbally or written, by agents and policy holders in

a timely response

• Prepared policy illustration, calculated tax information, and updated policy information using

Mainframe and Vantage Systems

• Used Equifax system for locating policyholders addresses

ADDITIONAL

TECHNICAL SKILLS

SOFTWARE: Windows XP, Windows 2000, Windows 95, Windows 98, Windows NT

Microsoft Access, Word, Office, Excel, Outlook, Megaveiw 3.2l, Internet,

Data Entry, Medical Manager, Centricity

Type 55 wpm

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