DeborahFisher

****hwy*** Hoschton,Ga*****

Phone:214-***-**** ad4ce2@r.postjobfree.com

Toworkforacompanythatchallengesmymindaswellaskeepingbusy. WellstarHealthSystems02/2019to 09/2022remote

A/RFollowuponaccounts,va,champva,Tricare,triwest,followgovernmentrulesforbilling Medicare,Medicaid..Prisoneraccounts,statefederalcityandcounty.,Ltachospitalsfederalfunded clinics.selffundedandstatefundedplansieforcancerpatientsetc.Commercialaccountsbcbs aetnauhclimitedbensupplementals,andfullyinsured.etc workerscomprebillifchargeshavenot beenreceived.contactinsuranceifpaymenthasnotbeen receivedorhasnotpaidwhatwe expectedtheaccounttopay.Workerscompwefollowstate guidelines,statefeeschedules.mental health,hospice,nursinghome,skilllednursingfacility’s..adjustmentsforinswriteoff,medicareand medicaiddualplans,adjoffbalance.adjustmentfordifferentwriteoffs.Rebillofhospital accountsthatproviderindicateswheretheydidnotreceivedbills. NTTData 03/2017-02/2019

Processedclaimsforcaliforniamedicareandmedicaid.Appealedclaimsdeniedmedicareand medicaid.Medi-caliscalilforniabasedmedicare.Whereautharerequiredforipandoutpatient procedures.Ifnoauthhadbeenobtainedyouwouldappealforauth.sometimestheybackdated theauth.sometimestheydidnt.Appealswerealwayssubmitwithmedicalrecordsand documentation.Forcoverage.

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StarAdministrators10/01/2015-03/30/17-remote

SeniorClaimsExaminerProcessclaimsforNewYorkState Medicare,Medicaid/adjustments,reprice Facility Medicaidclaimsmanualprocess,adjustments,rebilledmedicareandmedicaidclaims. customerservice adjustedmedicaidandmedicareclaimswhen,whenclaimswerebilledprimarywhen patientshadothercoveragethatwasnotmentionedorknownaboutbeforebilling. Specialinsuranceservices11/13-03/15 partialremote

Seniorclaimsexaminer

Processedmedicalclaims,dentalandvisiontierbenefits.Supplementalandprocessedgap medicalpolicy.processedadanddclaims.Processedlongtermdisabilityclaims.Medicare andmedicaid.Rebillasneeded.Customerservice.

GmSouthwestStudentInsurance05/01/2000-11/2013-telecommute Seniorclaimsexaminer-college,K-12

•Processmedicalclaimsformultiplegroups,medicareandmedicaid processedandrebilled. assistotherexaminerswithproblemswith processing,systemchangesdifficulties. Investigateadjust,reprocess,andresolvecomplex issues.processeddeathbenefitsfor students,correctandrebillhospitalandprofclaims.CustomerServiceandPriorityprojects forclaimsmanagerProcessedmedicalclaimsandadjustmentsPrimaryonallperdiem contractsandDRG contracts,MedicareandMedicaidInvestigateclaimsAdjustedclaims HIGHSCHOOL:Southcobb,Ihave30+yearsprocessingmedicalclaims,medicare,medicaidandself funded.Customerservice.systemepic,healthchangeforhospbillingIngenix,rims1,2,Diamond.