Customer Service Medical Billing

Carlene Warren

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

Clinton Township MI 48035

**************@*****.***

OBJECTIVE

To obtain employment in the medical field of medical billing and customer service EXPERIENCE

Company 1 Date

Blue Cross Blue Shield of Michigan 8/84-2/16

Direct Data entry

• Key claims form into system for Medicare, professional claims, inpatient and outpatient claims, also responsible for review of Mental health claims and benefits according to guide lines per BCBSM

• Responsible for seeking approval for prescription for Durable Medical Equipment, assisted in obtaining and reviewing medical records to forward on to RN for medical review.

Company 2 Date

Blue Cross Blue Shield of Michigan 8/84-2/16

• Customer Service Representative in Auto groups, National Groups, Medicare, Certification department and Prior approval.

• Work in Provider service department on inquires and claim adjustment. And also work in Provider area for pharmacy and updates of information files

• Customer service in member service all lines of business

• Hap Mid-West as a temporary in customer service answer calls setting up transportation request and resolving claim issues for member. Company 3

R1 hospital Billing Customer Service Representative 1/17-10/18 Responsibility

Work for Ascension Health handle billing accounts for Providence hospital Update demographics and enter demographics

Contact Insurance companies to verify insurance coverage Company 4

Dialog Direct

Responsibility 03/06/18-current

Handle call center calls for Horizon Blue Cross Blue Shield of New Jersey intake call from customers for billing hospital and professional services. Update Coordination of Benefits for other insurance member may have and adjust claims process incorrectly. Provide members benefits and other insurance company’s verification of eligibility. EDUCATION

School Date

Allied Schools 2/4/16

Degree(s) Certification in medical Billing (pending completion)

• Updated on new Current Procedural Terminology (CPT)

• Updated on new standard Edition of 2016 ICD-10-CMC

• Updated on billing changes according to billing of Medicare, Medicaid claims

• Billing of professional, inpatient and outpatient claims

• Completed Medical Billing Course August 2017

ADDITIONAL INFORMATION

Important/Significant Activities

Taking on line class in medical billing

• Receipt of Certificate of 30 years of service at BCBSM

• Certificate of completion of Medical Billing course. Achievements/Awards

• Retirement certification 2/1/2016

Technical/Computer Skills

• EDI system searching benefits, eligibility updates system,

• Benefits system for lines of business

• Claims and billing system, data base on codes and change updates

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