Amy Baier

**** * **** **** **** #****, Scottsdale, AZ 85255 ● 720-***-**** ● ad1w52@r.postjobfree.com

SUMMARY

Production-oriented claims professional with over 17 years in medical insurance claims processing and data entry.

Trusted to process highly classified claims of television and radio personnel, as well as those of company employees.

Have extensive experience in health claims dispute/resolution and adjustments, Workers’ Compensation claims, high-dollar transplant claims and bodily injury claims for auto policies.

Always meet and/or exceed quantity and accuracy quotas.

EXPERIENCE

Keying and processing claims in accordance with claims policies and procedures

Medical billing, collections, coding, payment posting, claims adjudication, appeals and EOBs

In-depth knowledge of ICD9, ICD10, CPT, DRG, HCPCS, as well as and medical terminology and procedures

Paid Medicare claims with established government policies and procedures

Identifying, correcting and documenting errors encountered during the claim’s submission process

Resolving disputed claims to correct payments to doctors and health care facilities

Processing claims of multiple health insurance plans simultaneously

Processing high-dollar and highly complex claims

Researching and verifying referrals, benefits, diagnosis codes and payment schedules

Adjusting claims to correspond with correct fee schedules

SKILLS

Self-motivated, organized, efficient and dependable

Worked with Benesys, Computrak, MediCom and several home-grown claims processing systems

Ability to learn and use new, complex computer billing systems

Use of basic office equipment

WORK HISTORY

AGIA

Claims Specialist (06/2022 – Present)

Community Medical Services (9/2021-06/2022)

Medical Biller

Chubb (4/2021-8/2021)

Customer Service Rep

Summit Administration (1/2020-4/2021)

Process Medical Claims

AMR (6/2019 – 1/2020)

Updating insurance

Billing ambulance charges

IHC Group (4/2019 - 5/2019)

Producer Contracting (Employed through Employment Agency)

Updating agents into system

Magellan Health (11/2018-3/2019)

Eligibility Processor I (Employed through Employment Agency)

Updated member records

Clerk Paper Claims (2/2018 – 10/2018)

CVS Health, Scottsdale, AZ

Process prescription claims form Medicaid and the Department of Defense

Mail out reject letters

Edgenuity, (6/2017 – 1/2019

Data Entry Operator (6/2017 – 1/2018)

Processed work orders for schools

Did extension on course

Health Claims Examiner (9/2009 – 3/2017)

American Federation of Television and Radio Artists (AFTRA), New York, NY

Claims Processor Senior Associate (2005 – 2009), Great West Insurance through 2008 then CIGNA after purchase, Denver, CO

Claims Services Processor (2003 – 2004), Nationwide Insurance, Inc., Dublin, OH

Healthcare Cost Specialist (2000 – 2002), Zurich Insurance Group, Columbus, OH

Benefit Approver (1996 – 2000), CIGNA, Columbus, OH

EDUCATION

Executive Secretarial Technology, West Virginia University Parkersburg, Parkersburg, WV

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