Leon McCoy

**** ******* ****

Louisville, KY ****7

ad2dto@r.postjobfree.com

502-***-****

Summary-

To obtain a position that will utilize my strong organizational abilities, healthcare expertise, communication skills, customer service experience and my computer knowledge in the workplace industry to include insurance, contracting, hospital, prescriptions, customer care and collections.

Work experience

Patient Care Coordinator/Shared Services/Customer Service/Specialty Pharmacy Intake

Patient Care Coordinator/Shared Services

United Health Group - Jeffersonville, July 2016 to October 2023

Daily intake calls resolutions, fax and verbal

Refill requests. Creating referrals. Working

Approved and denied prescription requests.

Sending ROR to providers for new referral verifications.

Systems utilized: Script Med, Citrix and Microsoft tools

Claims and Reimbursement Recovery specialist

Claims Review Corporation: April 2015 to January 2016

Medicare and Medicaid specialist

Agency Service Representative /Customer Service Call Center

Anthem BC BS of Kentucky: August 2010 to January 2015

Agent assistance with placing customers with insurance, assisting customers with exchange plans and customer call center. I succeeded as broker of the month on several occasions and was commended for my assistance by several agents.

Analyst reviewing underpaid claims.

Norton Healthcare System: April 2000 to October 2009

04/2000-10/2009

Managed Care Department/Insurance Contracting

Patient Collections, promoted to Denial Management Division

Review of denied claims by third party insurance plans. Promoted to Insurance Contracting

Analyst reviewing underpaid claims for correct reimbursements specifically to the contracts for third party insurance payers. Contact and communication with third party carriers for variance recovery in reimbursements and research of global trends of variance. Review of contracts to include refunds, development of excel spreadsheets, adapt knowledge of contract language and contract terms. Analyze coding, hierarchy interpretation of reimbursement. Monthly collection goals and monthly contracts met in a timely manner with all necessary follow up. Insurance claims processing and appeals processes completed.

Education

GED

ITT Technical

Skills

Analysis skills

Citrix

Research

Customer service

Scripting

Medical Collections

Managed Care experience

Work Information

I am proficient in Microsoft Word, Excel, Harvest, TSI, Star, Script Med, Citrix and several software programs within the healthcare industry.

Communication skills/Customer Service, insurance and healthcare providers.

Contract analysis with major managed care insurance carriers.

Excellent professional relationships with major third-party carriers and local insurance agents.

References upon request

Contact this candidate