Insurance Customer Service
Resume:
Denise Mays
San Antonio, Texas 78233
210-***-**** Cell
210-***-**** Home
Objective
To secure a position in medical billing which allows me to use my skills and experience to best advantage for my employer.
Skills:
- Exceptional customer service skills
- Exceptional experience in claims processing to ensure highest reimbursement
- Excellent verbal, written and interpersonal skills
- Excellent data entry skills (numeric 8000+/alpha 60-65 wpm).
- Proficient in Medic, Medictech, cps and Crystal reports, ICD9 and CPT coding
- Experience in QuickBooks pro software, Atlanta Base software,
- Able to multitask and respond to multiple enquiries while meeting deadlines
- Knowledge in excel
- Centricity software
- CPR+ software
- Iemphysis software
- Understanding and working with high dollar infusion claims
Professional Experience
Smile Brands, Inc
San Antonio, Texas 78229
Insurance Verification Specialist
January 27,2015 to present
Verification of all Houston area offices documenting in QSI software this process.
Walgreens Infusion Therapy
San Antonio, Texas
Oct 21, 3013-Dec 8, 2014
Claims Resolution Account Specialist
-Processing all claims by branch site from start to finish
-Workings with all insurances including Medicare and Medicaid
-Processing refunds for various insurances
-Meeting critical and important deadlines for various projects
-Billing for in home nursing and infusion claims
-Processing and understanding the difference between contractual and bad debt
reconciliation
-Locating difficult to find remittances through various websites such as zirmed,
emdeon and navinet
In home billing for nursing
(Cancer Care Centers of South Texas)-Ameritech
San Antonio, Texas
Sept 10, 2012-Dec 7, 2012
Senior Patient Account Specialist
- Processing all patient AR alpha accounts FL-HER
- Medicare/Commercial Insurance refunds
- Answering patient incoming calls regarding balances and payment arrangements
- Answering incoming calls from all insurance companies
- Claims resolution for Medicare, Medicaid and all insurances
Podiatry Group of South Texas
San Antonio, Texas
April 2011-September 7, 2012
Insurance and Patient AR Refunds
Insurance collections
processing of all patient refunds and adjustments
processing of all insurance refunds and adjustments
Answering incoming calls from patients regarding outstanding balances
Contacting insurances regarding outstanding balances due
Position: Intermedix (formerly Alexander Billing and Consulting)
San Antonio, TX
July 2008-July 2010
Position: Billing Specialist
- Claims Resolution Specialist for Medicaid, Medicare and commercial insurance companies
- Handling up to 30 calls per day with successful resolution
- Medicaid State Appeals
- Insurance verification
- Imaging of claims
- Investigating and resolving Patient disputes
Nov 2004 – June 2008
Michael A. Roman, Ph.D.
San Antonio, TX
Clinical Psychologist
Position: Office Manager
- Claims filing
- Payment posting
- Collections
- Appeals and resolution of disputes
- Insurance verification
- Scheduling of appointments and credentialing
- Gained in-depth knowledge of Medicare, Medicaid and commercial insurance claims processing
Reason for leaving: to focus more on medical billing and claims adjudication
March 2004-Oct 2004
Alamo Physician Services
San Antonio, TX
Position: Accounts Receivable Posting Specialist
- Payment posting for 12 emergency facilities
Reason for leaving: Position eliminated as part of reduction in force
Oct 2002-Feb 2004
Caring Senior Services
San Antonio, TX
Position: Human resource and payroll manager
- Managing payroll for nine franchise companies and corporate office.
- Screening applicants for future employment through company job line, securing background checks and processing of applications.
- Handling of Texas Workforce claims and disputes and processing quarterly taxes for each franchise as well as setting up accounts in QuickBooks for new franchisees
- Assisting in coordination of franchise meetings.
Reason for leaving: Found employment closer to home
Feb 2001-May 2002
Wheat Ridge Internal Medicine
Denver, CO
Position: Accounts Receivable Specialist
- Pulling of bi-weekly AR reports,
- Insurance follow up and collections,
- Payment posting of Medicare remittances,
- Processing Medicaid health insurance claim forms and
- Credentialing of physicians.
Reason for leaving: Relocated to Texas
Oct 1996-Jan 2001
Gnathodontics
Denver, CO
Position: Assistant Office Manager.
- Greeting customers
- Handling of all incoming calls,
- Billing,
- Payment posting
- Handling incoming and outgoing mail, overnight courier and shipments.
- In charge of dispatching three couriers.
Reason for leaving: To focus on medical billing field
Education:
Natalia High School, Natalia, TX – diploma
References provided upon request
Contact this candidate