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Insurance Medical

Location:
Elmhurst, IL
Posted:
February 27, 2016

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Resume:

Dawn Glitto

**** *. ****** ***.

Elmhurst, IL. **126

630-***-****

actpzd@r.postjobfree.com

CAREER SUMMARY

Medical claim billing specialist with 15 years of experience seeking employment within the industry.

Basic knowledge of Claim denial appeals Quality control

medical coding Claim follow-up A/R special

Claim billing Detail oriented projects

Electronic claim clearinghouses Multi-tasking Trainer

Explanation of benefits (EOB) Appeals

PROFESSIONAL EXPERIENCE

Advantedge Healthcare Solutions Lombard, IL.

Follow-up Specialist- full time remote employee

Worked denial ansi-code, determining balance liability

Trained employees to work claim denial follow-up, update insurance information, and patient

demographics

Directed issues to the appropriate departments

Worked A/R special projects handling outstanding claims

Follow up with insurance companies to determine claim submission errors and correct them

Worked front end claim rejection issues using electronic claim clearinghouses

Established and maintained positive working relationship with other employees and venders

Confirmed the accuracy of and verified insurance benefits for new and existing patients

Examined back office claim rejection issues and worked with Insurance entities to resolve them

Maintained a professional working relationship with all government and commercial Insurance

entities to facilitate claims payment

Submitted appeals for incorrect insurance adjudications

Maintained the confidentially of all patient information in accordance with Wellness and HIPAA

policies

Worked with medical Diagnosis Coding and CPT coding

Completed HIPAA courses keeping up to date through 2015

TECHNOLOGY

Microsoft Office Suite

Virtual Manager

Legacy

Emdeon Vision

Availity-Realmed

Government and Commercial Insurance web access



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