Customer Service Insurance
Resume:
SHAWN EDWARDS-DUNN
************@*******.***
OBJECTIVE: Obtain a challenging position, which enables a dedicated professional to exercise a high degree of initiative, judgment, discretion and decision-making to achieve department and organizational objectives.
PROFESSIONAL SUMMARY: Dedicated insurance professional with more than 5 years of experience investigating and processing medical insurance claims, reconciling insurance payments/patient patients and resolving disputes in an outpatient setting. Excel in analyzing claims, interpreting policies/procedures and negotiating payment solutions. Effectively manage multiple office locations, high-priority projects and take pride in providing exemplary customer service to patients and support staff
* Proficient in Microsoft Office products
* Follows compliance plan standards and department policies/procedures
* Effectively communicate through written and verbal forms of communication
* Medical Collections
PROFESSIONAL EXPERIENCE
EHP Behavioral Services LLC 2011 – 2014
Sr. Patient Accounts Representative
* Ensure that account follow-up and collection techniques meet laws, regulations and guidelines governing billing and collections in a outpatient health care facility
* Prepare and submit primary/secondary clean claims to various insurance companies electronically or paper
* Maximize collection productivity and accuracy by ensuring account follow up is done according to department collection philosophies and standards
* Process payments and reconcile daily batches
The Center For Cancer and Blood Disorders 2007 – 2009
Office Coordinator
* Conducted new patient intake to determine patient benefits
* Completed pre-determination/financial clearance for all new and recurring patients
* Reimbursement rate changes / fee schedule adjustments
* Performed charge entry and daily claims submission via electronic clearinghouse and paper claims
Hematology/Oncology Associates 2000 – 2007
Sr. Billing Specialist
* Supported billing manager processing a high volume of insurance claims according to federal regulations
* Posted and reconciled insurance and patient payments
* Prepare and submit primary/secondary clean claims to various insurance companies electronically or paper
* Outpatient/Facility Credentialing
* Train all new department staff
* Ensured compliance with policy provisions, state and federal regulations, and exercised expense management through investigation; appropriate follow up; case management and claim settlements
EDUCATION
Sawyer Business School
Certificate - Medical Billing & Coding
References Furnished Upon Request
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