Insurance Manager
Resume:
Cynthia Cunningham
Columbus, OH 43211
*******.**************@*****.***
Office Professional
Well organized, motivated, Billing and Coding Professional who has strong communication skill set, and attention to detail. Motivated leader with strong organizational and prioritization abilities.
Core Strengths
Certifications: CBCS, CMAA, Information Technology
Completed Medical Administrative Billing & Coding with 3.66 GPA
Medical Terminology
ICD-9-CM, ICD-10-CM conversion, CPT and HCPC's coding.
Anatomy and Physiology
Processing Claims (According to State mandates for timely filing).
Audit Report and Statistics
Employee Assisted Programs
HIPPA/PHI Overview:Privacy and Security
Research for coding and Payment Delays
PROFESSIONAL
EXPERIENCE
Plumbers & Pipefitters
Local Union 189
Columbus, Ohio Jan. 2016 – Present
Use computers for various applications, such as database management or word processing.
Perform payroll functions, such as maintaining timekeeping information and processing and submitting payroll.
Answer telephones and give information to callers, take messages, or transfer calls to appropriate individuals.
Create, maintain, and enter information into databases.
Set up and manage paper or electronic filing systems, recording information, updating paperwork, or maintaining documents, such as attendance records, correspondence, or other material.
Operate office equipment, such as fax machines, copiers, or phone systems and arrange for repairs when equipment malfunctions.
Greet visitors or callers and handle their inquiries or direct them to the appropriate persons according to their needs.
Complete forms in accordance with company procedures.
Home Health Aide
Home Healthcare
Columbus, Ohio Oct. 2014 – Dec. 2015
Maintain records of patient care, condition, progress, or problems to report and discuss observations with supervisor or case manager.
Administer prescribed oral medications, under the written direction of physician or as directed by home care nurse or aide, and ensure patients take their medicine.
Check patients' pulse, temperature, and respiration.
Provide patients with help moving in and out of beds, baths, wheelchairs, or automobiles and with dressing and grooming.
Care for patients by changing bed linens, washing and ironing laundry, cleaning, or assisting with their personal care.
Plan, purchase, prepare, or serve meals to patients or other family members, according to prescribed diets.
Accompany clients to doctors' offices or on other trips outside the home, providing transportation, assistance, and companionship.
Direct patients in simple prescribed exercises or in the use of braces or artificial limbs.
Perform a variety of duties as requested by client, such as obtaining household supplies or running errands. Change dressings.
Billing Reimbursement Specialist (Medical/Pharmacy)
Bioscrip Pharmacy
Columbus, Ohio Feb. 2007 – Sept. 2014
Analyzed explanation of benefits (EOB's) to detect payment discrepancies and payer trends to determine appropriate follow-up i.e. re-submissions, adjustments and or refunds for varies insurance claims, including worker's compensation, BCBS for all states, United Healthcare, Aetna, and Medicare/ Medicaid.
Effectively communicated with patients, physicians' offices, hospital personnel and all IPMS staff in relation to billing, insurance and general information, to build and maintain positive business relationships.
Accurately recorded daily credit card totals, distributed vouchers and posted EOBs manually and electronically.
Handled monthly payment reconciliation and collection agency turnover process for HPA.
Cross-trained members of my team on billing and daily tasks functions to ensure production goals are being met.
Researched and developed claim corrections to be submitted to the commercial payers.
Read and interpret medical records of patients.
Accurately assign diagnostic and procedural codes according to ICD-9-CM, ICD-10-CM/PCS, and CPT coding systems using federal coding compliance guidelines; review the coding done on the encounter forms for accuracy.
Perform mathematical calculations for submitting insurance claims including deductible amounts, allowed amounts, secondary insurance allowed amounts and patient's responsibility.
Act as a resource to patients, families, physicians, and office staff regarding insurance coverage for specific procedures.
Office Manager
Primerica Financial
Columbus, Ohio Sept. 2000 – Jan. 2007
Increased vice presidents pay rate by 30%.
Managed 6 service support staff; schedule creation, payroll, escalations, and training with a budget of $80,000.
Coordinated health and life insurance claims.
Prepared insurance packets.
Resolving customer problems quickly to build goodwill and increase repeat and referral business.
Filed insurance forms and other documents.
Reviewed insurance claim forms.
Scheduled appointments for agents.
EDUCATION
McED Career College Online
Medical Administration with specialization in billing and coding
Fresno, CA 2009
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