Phone: 516-***-**** Email: email@example.com
Address: **** **** ****** ***, *********, CA 93536 SUMMARY OF QUALIFICATIONS
Versatile, highly qualified, and dedicated Healthcare Insurance Claims Specialist Candidate with a wide range of successful hospital bill/claims processing, contracts, benefits, provider services and medical data analysis experience. Adept at analyzing various healthcare data, collaborating with vendors, preparing financial reports, and working with CPT, ICD-10, HCPCS with Modifiers, and EMR software systems. Consistently maintains compliance with various medical insurance/billing policies and regulations while managing a high volume of database entries for inventory and hospital billing initiatives. Currently seeking Healthcare Insurance Claims Specialist position by demonstrating the following skills, qualifications, and experience. AREAS OF EXPERTISE
• Healthcare Insurance Claims
• Plan/Benefit Administration
• Process Improvement
• ICD-10/CPT & HCPCS
• EMR Software Implementation
• Insurance Claims Processing
• Medical Terminology
• Abnormality Identification
• Record/File Maintenance
• Medical Billing/Coding
• Account Management
• Provider/Vendor Relations
• Bill/Claims Examination
• Database Administration
• Fee Scheduling/UCRs
Optum360/Northwell Health Accounts Receivable Clerk Nov. 2018 – Present
• Responsible for working several patient accounts daily while preparing itemized bills, UB04, and medical records to be sent to various insurance carriers for payment.
• Handle all matters pertaining to patient billing and medical insurance claims processing. Coram Healthcare/CVS Infusion Pharmacy Clinical Support Specialist Jun. 2012 – Nov. 2018
• Assisted pharmacists by entering prescription data and new orders to be reviewed while contacting patients to discuss medication and supply deliveries, as well as dispensing IV antibiotics via HCN.
• Collaborate with nurses regarding patient care, manage accurate deliveries by communicating with compounding staff, and work with billing personnel to verify insurance coverage of drug therapies.
• Programmed Curlin and CADD pumps for use in patient homes, as well as enter prescription data to obtain co-payments.
New York Blood Center Clinical Service Representative Apr. 2006 – Feb. 2012
• Performed quality reviews and ensure that blood center maintains FDA compliance regarding donation procedures, as well as data processing and hospital billing.
• Managed inventory and HLA/Granulocyte order processing, as well as audited nursing department and assisted with data control, microfilming, and retention tube processing. EDUCATION & DEVELOPMENT
Hunter Business School
Medical Billing & Specialist Diploma
National Healthcare Association
Certified Pharmacy Technician