Manager Insurance
Resume:
Debra Brown
MILLERS CREEK, North Carolina 28651
Objective:
To obtain employment to which I can best utilize my experience and knowledge .
EXPERIENCE:
**/**-present
Accounts receivable and Billing Office Manager
West Florida Medical Specialists
5622 Marine Parkway, Suite 14
New Port Richey, Florida 34652
Duties:
Process and apply insurance and patient payments to the appropriate
account. Run accounts receivable reports and contact insurance
Companies regarding delinquent accounts. File appeals on rejected claims to
obtain reimbursement. Obtain authorizations for outpatient procedures. Verify
benefit and eligibility on new and existing patients. Send monthly statements
to patients with outstanding balances. Negotiate contracts with insurance
companies to
insure the highest level of reimbursement. File claims with both primary and
secondary Insurance companies with the use of ICD9 and CPT coding. Assist and
instruct staff members on diverse office duties and job performance. Provider
credentialing for renewals and new insurance product. Experience working with
Eclinical, Nextgen and Medical Manager.
04/07-02/10
Wilkes Regional Medical Center
Patient Access Representative
1370 West D Street
North Wilkesboro, NC 28659
Register emergency patients both walk in and thru EMS. Obtain all demographic
and insurance information from the patient or family members. Keep critical
patients family members comfortable and informed on status of their family
member. Contact the appropriate authorities for patients with questionable
cases or suspicious symptoms. Process and assist active labor patients to the
labor and delivery department to assure their safety. Alert security of any
potential problems in the department. Obtain authorizations for surgical
procedures performed in the operating room.
10/02-0/04 Claims Analyst
Florida Benefit Administrators
13080 South Belcher Road
Largo, Florida 33773
727- 530-4144
Duties:
Account manager for assigned self-funded employer groups. Provide human
resource personnel with employee medical, dental and prescription benefit and
enrollment information. Process medical, dental and prescription claims for
payment according to the plan contract. Meet production and audit
requirements set for all accounts. Investigate and obtain information for
pending claims. Assist members and providers with benefit and claim
information.
04/99-07/02 Claims Analyst
Boon Chapman TPA
12301 Research Blvd, suite 400
Austin, Texas 78759
Duties: Account manager for assigned self-funded employer groups. Provide
human resource personnel with employee medical, dental and prescription
benefit and enrollment information. Process medical, dental and prescription
claims for payment according to the plan contract. Meet production and audit
requirements set for all accounts. Investigate and obtain information for
pending claims. Assist members and providers with benefit and claim
information.
06/97-3/99 Medical Receptionist
Jerry Patey, M.D.
5427 Water Street
New Port Richey, Florida 34652
Duties: Bill the appropriate insurance companies with use of ICD 9 and CPT
coding. Order and stock office supplies. Send monthly statements for
outstanding patient accounts. Post insurance and patient payments to the
proper account. Schedule appointments for office and outpatient procedures.
Obtain authorizations for outpatient procedures as needed. Perform basic labs
including urinalysis, stool occults and administer flu vaccines. Call in
prescription refills and inform patients of test results.
05/87-02/97
Medical Receptionist/Office Manager
Thomas Fruzynski, M.D.
20 Commerce Way
Succasunna, NJ 07876
Duties: Responsibilities include patient scheduling for office visits and
outpatient procedures. Obtain authorization for patients requiring outpatient
procedures. Bill for services with use of ICD9 and CPT coding both primary
and secondary insurances. Contact insurance companies for delinquent claims.
Keep daily log sheet of payments received patient and insurance. Do daily
bank deposits. Order office and medical supplies. Assist doctor with
patients, process all labs. Send monthly statements to patients with account
balances. Call in prescriptions and inform patients of test results.
Certificates and license:
Licensed insurance agent in the State of North Carolina for health, life and
annuities.
Certified in phlebotomy
Multiple certificates in insurance coding
References:
Lisa Dunn
Owner of Dirt Worx Excavating
Donna Hamilton
Office Manager
Florida Benefit Administrators
Judy Castillo
Manager Boon-Chapman TPA
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