Insurance Manager

Deborah Smith

***** ***** ***** • Cypress, Texas 77433

832-***-**** • *****************@*****.***

ADMNISTRATIVE/CUSTOMER ASSISTANT

Experienced professional with excellent customer communication skills, in person and over telephone.

Asks useful questions, listens actively, and helps customers navigate processes, answering questions and solving problems.

Able to manage variety of office tasks with attention to detail and organization. Prioritizes multiple deadlines.

Familiar with Microsoft Word and Excel. Types 62 wpm; able to 10-key.

EXPERIENCE

Nanston Dental Inc., Norcross, Georgia • 2000-2003

Oral Surgery Coordinator

• Worked in oral surgery department of multi-service dental practice with between 20 and 30 locations throughout Georgia.

• Contacted insurance companies to obtain payment for claims.

• Researched claims to determine whether insurance companies had already made payments, and if they had paid correct

amount; contacted patient for remittance of balance if one remained after insurance payments.

• Pulled Explanations of Benefits (EOB) to verify procedures that were done.

• Faxed copies of requested information to insurance companies for use in claims processing.

• Prepared monthly collections report, showing accounts in arrears; information was used to determine when files were sent to

internal collections department and when they were sent to external collections agencies.

• Made calls to patients whose accounts were due, to determine whether they could make full or partial payments before their

files were sent to collections.

• Provided collections department with history of invoices, claims, and payments for particular patients.

• Collaborated with team tasked with establishing efficient processes for oral surgery department. Trained secretaries in

satellite offices on best practices to help their jobs run more smoothly.

• Trained new employees coming into department in daily process es and use of computer system.

Blue Cross Blue Shield of Oklahoma, Tulsa, Oklahoma • 1991-1999

Claims Examiner IV • 1995-1999

• Used computer system to research dental codes and provider tax information for claims processing.

• Verified member and provider information on claims. Contacted providers to request corrections on claims.

• Entered information on dental claims for government employees into computer system and approved for payment.

• Met and frequently exceeded monthly quota of claims to be ent ered.

• Assisted in monthly quality improvement meeting where processes were reviewed and evaluated for possible streamlining.

Learned about new types of claims and codes and changes to computer systems.

Document Control • 1991-1995

• Received claims soon after they arrived and initiated processing; numbered, copied, and printed claims and ensured each item

was filmed for back end logging.

• Verified all information was accurate on claim and in computer system.

• Contacted providers if errors were found; ensur ed all mistakes were corrected before processing continued.

• Filed logged claims for processing.

• Learned all eight claim types and trained new employees on all claim types.

• Selected by manager to participate on team tasked with creating brochure for members that explained steps required to

receive benefits through Medicare.

• Met with members on-site at assisted living centers and retirement homes to distribute and explain Med icare brochure.

EDUCATION

Coursework, Business/Administration, Oklahoma Baptist University, Shawnee, Oklahoma

One Year Completed

COMMUNITY INVOLVEMENT

Ridge Elementary, Plainfield, Illinois • 2007-2012 Jackson Elementary, Lawrenceville, Georgia • 1999-2003

Volunteer Volunteer

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