Customer Service Medical Records
Resume:
Tina Cless
New Bloomfield, PA *****
ad0rmu@r.postjobfree.com
Work Experience
Records Retrieval Agent
Randstad - Mechanicsburg, PA
April 2022 to October 2022
Called hospitals, doctor offices, and nursing homes for patient medical records for insurance companies. Updated facility information on the system to keep everything up to date. If the provider or patient was not at the location, I searched to find the correct location where medical records would be to send a request.
Support Clerk
Novitas Solutions - Mechanicsburg, PA
February 2015 to March 2019
Open, sort, and prep mail to be imaged into the system. Input check information of the member and provider onto excel spreadsheet. Research and write correct member addresses so checks get sent to the right location.
Claims Adjuster
Highmark Blue Shield - Camp Hill, PA
January 2012 to March 2014
Collect or recollect refunds, adjust, and adjust process claims. Research projects for the Business Analyst, review payments of claims and adjust if need.
Inquiries from Customer Service or from the Provider to have claims adjusted so they are paid correctly. Coordination of Benefits Contract Specialist
Highmark Blue Shield - Camp Hill, PA
April 2003 to April 2003
Investigate, analyze, and interpret inquiries complex in nature from the provider and other units for proficient claims processing according to group benefits. Determine primacy and coordinate benefits with other insurance companies when members have duplicate insurance coverage and set up request for refunds. Display customer professionalism while making and receiving phone calls with members, provider, and other insurance companies. Education
high school diploma
west perry senior high school
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