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Senior Associate Medical Claims

Location:
Orlando, FL
Salary:
52000
Posted:
March 22, 2024

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Resume:

Kristin Clark - Rider

Senior Administrator

**** ********** *** ****** ******, Florida 34787

816-***-****

Kris I ad4imh@r.postjobfree.com

Highly motivated and committed Senior Associate with proven history of superior performance at individual, team, and organizational levels. Multitasks and prioritizes workloads with little or no supervision. Detail-oriented professional looking to bring my current skills and team-building knowledge to a deadline driven environment. Effective Senior Associate with a strong background building rapport with team members and outside associates alike. Driven performer equipped to handle multiple, administrative tasks effectively. Exemplary worker with high investigative / research skills when completing assignments.

Work History

09/2022 - Current Montverde Academy Senor Medical Associate Montverde Florida

• Schedule appointments, register patients, and distribute pharmaceuticals as prescribed.

• Obtain client medical history, medication information, symptoms, and allergies.

• Complete clinical procedures and gather patient data for interpretation by physician.

• Document vital signs and health history for patients in clinic and hospital environments.

• Call and fax pharmacies to submit prescriptions and refills.

• Collect and document patient medical information such as blood pressure and weight.

• Keep medical supplies in sufficient stock by monitoring levels and submitting replenishment orders before depleted.

• Sanitize, restock, and organize exam rooms and medical equipment.

• Perform medical records management, including filing, organizing, and scanning documents.

• Verify patient insurance coverage and collect required co-payments.

• Answer telephone calls to offer office information, answer questions, and direct calls to staff.

• Conduct monthly and quarterly inventory of supplies using facility cost reporting records.

• Reconcile all expenses coming into and going out of the Infirmary.

• Plan and organize as well as conduct meetings on care, expenses, improvements happening within the Infirmary Staff

• Schedule Infirmary Staff for all upcoming events where medical staff will be required.

• Work hand in hand with the Academy Athletic trainers on improving the care and experience for our boarding students.

• Work with Academy Associates on scheduling all big sporting events that take place on campus. 06/2011-08/2022 GEl-IA - Senior Medical Associate

Independence Missouri

• Examined claims forms and other records to determine coverage for claim audit.

• Answered customer questions regarding coverage.

• Paid, denied, and audited medical claims based upon established claims processing criteria.

• Used administrative guidelines as resource or to answer questions when reviewing medical claims.

• Managed large volume of medical claims on daily basis.

• Responded to correspondence from insurance companies, providers, and facilities.

• Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures in alignment with HIPAA regulations.

• Identified and resolved discrepancies between patient information and claims data.

• Assessed medical claims for compliance with regulations and corrected discrepancies.

• Monitored and updated claims status in claims processing system.

• Verified patient insurance coverage and benefits for medical claims.

• Processed insurance payments and maintained accurate documentation of payments.

• Supervised a 12-15-person team within the claims department.

• Scheduled and planned employee coverages to ensure all shifts were covered.

• Maintained employee reviews submitting promotion approvals when applicable.

• Trained up and coming claim auditors.

08/2019 - Present Arrowhead South - Orlando Chapter I'm also the director and organizer of an 800-member group that meets weekly. I plan all events from hotel stays, meals, and travel. I work closely with group members, ensuring their satisfaction from start to finish when it comes to game day experience and everything leading up to game time. I work closely with past players to schedule / plan meet and greet opportunities as well as making sure their needs are met with travel, meals, and transportation. I work closely with all venues to ensure proper set up and accommodation are met. I plan yearly charity events within the group that benefits different organizations within the national football league. I also run all social media pages for the Orlando chapter.

Education:

2003 - Graduated from William Chrisman High School receiving a diploma 2004 - Studied Business Administration at Maple Woods college 2010- Completed EMT / Paramedic Training through AMR First Responders Service / Certificate 2024 - Completed Medical Billing and Coding through Florida Technical College / Certificate References:

Tiffani Law - Montverde Academy 352-***-****

Noelle McQuinllin - Arrowhead South 407-***-****

Melanie Williams - GEHA 816-***-****

Morgan Quattrociocchi - Arrowhead South Perner #00737997



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