Insurance Customer Service

Alicia Cole

*** ******* ** **********, ** ***** Cell: 281-***-**** Email: ****.****@*****.***

CORE MEDICAL SKILLS & QUALIFICATION: Medical Billing, Coding, Insurance Follow-up, Insurance

Verification, Payment Posing, Medicare, Medicaid, Tricare, Manage Care, & Third Party Payers, CMS 1500, CM

1450(UB04), HIPPA Compliance, Medical Law & Ethics, Medical Terminology, EDI & Paper Remittances & Denials

(EOB’s), Appeals, Account Reconciliation, Data Entry, & Collection.

Dr. Kenrick J Dennis, Houston, Texas

Insurance Biller

• Charge entry of super bills, bill hospital and clinical charges

• Claims transmission all carriers -Medicare/Medicaid, Tricare, Manage Care, & commercial ins

• Post A/R, payment, contractual adjustment, write-off/no pays

• Insurance follow-up

• ICD-9 and CPT coding & correct coding

• Bill primary and 2ndary insurance

• Review/post electronic and paper remittance EOB reports

• Resolve understanding claim balances

• Research denied or underpaid claims

• Rebill and appeal with corrected coding

• Bill patient statements

• Account reconciliation and document in Wisdom

• Schedule clinical appointments and outpatient surgeries

• Process correspondences via mail/fax

• Request refunds and balance transfer

• Create batch reports, process daily close out

• Run daily charge and receipts summary

• Balance daily A/R

• Create daily bank deposit

• Collection

• Answer phones

• Customer service

Memorial Pulmonary & Sleep Disorder, Houston, Texas

Insurance Biller and Administrative Assistant

• Billed clinical visit, sleep studies, DME services, & hospital charges

• Posted A/R (payment) and contractual adjustment, error adjustment

• Insurance follow-up (resolves underpaid and unpaid claim)

• ICD-9 and CPT coding and corrected coding

• Billed primary and 2nd insurance, appeals, rebills

• Insurance verification and pre-certification

• Financial consulting responsible party of account balance

• Patient check in/out, cashier and collected co-pays/co-insurance and deductible

• Scheduled appointments and testing/outpatient procedure

• Ordered DME equipment and supplies, office supplies, and sample medications

• Registered patient, created new patient charts, and updated demographic

• Answered phones and processed correspondences

Alicia Cole Resume continue

UT Health Center at Tyler, Tyler, Texas

Patient Account Representative

• Insurance follow-up, requested refunds, & appealed denials

• Posted write-off adjustment

• Processed Tricare and commercial insurance EOB’s

• Resolved outstanding insurance balance

• Adjusted claims, contractual write-offs, & posted no-pays

• Billed primary and 2nd insurance

• Reviewed EOB’s for correct payment/adjustment and created reports

• Appealed w/documentation

• Corrected coding error and ICD-9 and CPT coding

• Researched denied or underpaid claims

Texas Children’s Pediatric Associates, Houston, Texas

Front Office Specialist

• Entered charges for super bills

• Billed insurance

• Checked patient in and out

• Collected co-pays and/ or co-ins.

• Insurance verification and updated demographics information

• Resolved outstanding claim balances and entry account adjustments

• Processed daily close out and run daily charge and receipts summary

• Balanced daily A/R and calculated self- pay discounts

• Created daily bank deposit

• Scheduled appointments and answered multi-line phones

Computer Software: MS Windows 95 - 98, NT Workstation, MS Word, Excel, PowerPoint, Access, MS Windows XP,

MS Office 2000 Professional, MS Windows 7 & 8, MS Vista, Google Chrome, Internet Explorer, Firefox, Safari, MS

Outlook Express, Medisoft, Medic, ASCII Navigator, Siebel, Digex, Meditech, Imaging Processing, One Source,

Citrix ICA System, Magic, Mysis, ResMed, Respironics, Gateway, & Paging System

EDUCATION BACKGROUND:

St. Leo University, Tampa, Florida

Computer Information System

Panola Junior College, Carthage, Texas

Data Processing

Graduate, Carthage High School, Carthage, Texas

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