Customer Service Insurance
Resume:
Tanya E. Mayo
Springfield, NJ **081
Tel.: 201-***-****
Email: *********@*****.***
Career Objective
I would like a challenging position that will utilize the skills I have learned over the years, which would male me an asset to the company.
Career Achievements/Qualifications
- Seven years plus, experience handling AR, collections and clerical tasks with MS Office Word, Excel and Access knowledge.
- Deliver quality customer service and client satisfaction.
- Work efficiently in independent environments, accomplish and surpass establish goals.
- Efficient in keeping records and reports.
- Strong ability to analyze with knowledge of billing and medical terminology.
Employment
McKesson (thru Medix Agency - Somerset, NJ-Billing Specialist
September 2014 to April 2015
Responsibilities
I work on denied claims, review, and reprocess as needed for payment or adjust off as required to process claims smoothly. I work credit reports for patients who have over paid at some point, by processing a request for a check to be issued to the guarantor. I take calls from patients who received a statement and looking to make payment or have account questions. I work on the collection company report to verify claims that should really be in collections.
Zotec/MMP-Billing Specialist-Projects Team
August 2013- July 2014
-Ran denial and global claims reports weekly and worked as to be adjusted, researched/reprocessed correctly also added to the shared drive for others to work on their projects
--denials such as possible duplicate claims, no authorization, no referral/incorrect number on claims,
incorrect denial of claim due to PCP,
Incorrect denial as new patient status and eligibility/COB denial claims.
-Researched modifier issues when to use and not use to use on claims
-Made calls to insurance Representatives to question for reprocessing
-Reprocessing claim hard copy through Epremis
Systems used- HPP, HPP Online, Star, NHXS, Epremis and Chart Max
Neighborhood Health Service Corporation - Senior AR Clerk - May 2005- August 2012
- Post all payments from Eobs to the appropriate accounts.
- Prints secondary claims, attaches primary Eob and mail for payment.
- Review remittance advices to ensure payments were made per procedure.
- Contacts insurance companies and other payers in an effort to collect denied claims.
- Verify correct codes to ensure prompt payments
- Make adjustments to the computer classification of claims to most accurately reflect the expected pay source.
- Contacts patients as necessary regarding account information.
- Establishes payment plans with patients in accordance with department policies and procedures to ensure timely payment of outstanding balance.
- Provides coverage for all departments as needed OBGYN, Adult Med, Pediatrics Dental, Eye and Podiatry
- Record daily patient count OBGYN, Adult Med, Pediatrics Dental, Eye and Podiatry
- Post encounters for all departments OBGYN, Adult Med, Pediatrics, Eye and Podiatry
- Run monthly tallies to verify correct postings all departments OBGYN, Adult Med, Pediatrics Dental, Eye and Podiatry
- Review patient accounts, adjust as needed, send out bills and answer patient questions
- Post Eob payments and work denials
- Assist IT with all types of reports and general questions
-Assist managers for audits and run requested AR reports. I.E. General ledger trial Balance
- Work wraparound report for presentation to the state
- Maintained a Medicaid spreadsheet of all checks received for all facilities
- Maintained cash receipts spreadsheet for all monies received verse back statement and helped controller with the monthly report of this
- Update ICD9 and CPT codes, provider information and new insurance carriers information into the master table along with yearly fee schedule information as needed.
- Process refund requests by patients and insurance carriers.
- Sat in on all meetings required to set up EHS tables, training for employees and start date kick off.
Summit Medical Group - Registrar - 1994-2003
- Booked and confirmed appointments.
- Checked in and out patients.
- Received and posted patient payments and maintained daily batch balance.
- Processed new patients, verified and updated insurance information.
Skills Used
I used my excel spreadsheet skills along with problem solving and research skills to find accurate patient id, referral info and other information to process claims smoothly.
Education
Jonathan Dayton Regional High School 1991
Springfield NJ
Continuing Eductaion Classes in Business Management at:
Bethune-Cookman College 1991-1992
Daytona Beach FL
Kean College 1992-1994
Union, NJ
Reference
Upon request
Contact this candidate