High School Accounts Receivable
Resume:
Trina Clark
ad5nqf@r.postjobfree.com
Education:
Brandon High School
Major: High School Diploma
Professional Experience
Alignment Healthcare
Claims Processor
●Aided in the correction of procedure and diagnosis codes to allow payment from the insurance company
●Assisted patients in creating payment plans, getting discounts, and medical assistance to prevent their accounts from going to collections
●Payment by insurance carriers and achieve timely billing and prompt accounts receivable turnover (CIGNA, AETNA, HUMANA, BCBS, MEDICARE)
●Implemented electronic claims transmission system. Electronic claims submissions, appeals, authorization tracking, patient accounting, interaction and implementation of patient payments on delinquent accounts
●Billing plans such as HMOs, PPO plans, Dental plans, Medicaid, Medicare
●Traditional medical plans to complex managed care arrangements.
●Works communicates and collaborates in harmony and in a courteous and professional manner with the patient, practitioner, provider and multidisciplinary health care team members all issues, concerns and/or as the UM Plan is revised and/or new services are implemented/terminated corresponding and adjustment via Xcelys/FACET
●Billing plans such as HMOs, PPO plans, Dental plans, Medicaid, Medicare
MH Consulting (Contract)
Claims processor
1/2018-4/2018
●Performed claim review, processing and adjudication
●Reviewed claim for data and payment accuracy
●Finalized claim for denial of payment
●Reviewed and confirm contracts
Health Plan Services
Senior Claim Specialist
October 2015-January 2018
●New Business Auditor- Auditing of new hire work, creating spreadsheets for feedback and providing reports of Audit roll up and progression to management
●Onboarding- Lead trainer for iGate resources for the new business off exchange portion. Lead contact for any questions they had after training and additional training.
●Managed a wide variety of customer service and administrative tasks/projects to resolve member billing and health plan policy issues quickly and efficiently.
●Provided member policy plan maintenance that included demographic change, dis-enrollment, reinstatement, and plan/policy change.
●Processed 834 files for BSC On exchange
Senior Customer Care Associate
June 2014-October 2015
●Recommended health insurance products and services to members (customers) and accurately explained details of services and plan benefits.
●Managed a wide variety of customer service and administrative tasks/projects to resolve member billing and health plan policy issues quickly and efficiently.
●Provided member policy plan maintenance that included demographic change, dis-enrollment, reinstatement, and plan/policy change.
Candidate Qualification Summary:
10+ years of claim experience
8 + years of healthcare member benefits experience
5+ years of healthcare enrollment experience
Experienced with Microsoft Office Products
Available Mon-Fri 8am-8pm + Overtime as needed
Contact this candidate