Medical Billing Claims Processor
Resume:
Dolores Newcomb
**** ******** **** ****, *******, TN 37013
************@*****.***
January 10, 2019
To whom it may concern:
I have worked with the Medicare Program in Nashville for over 49 years. During this course I have acquired skills in the following areas:
English Language/Writing
Time Management/ Active Listening
Customer and Personal Service/Complex Problem Solving
Critical Thinking Law and Government of the Medicare Program/ Judgment and Decision Making
Reading Comprehension/Clerical
The various duties I have performed in the Medicare Program can benefit your office. I am a team player and I am very enthusiastic of learning new job duties. I think my dedication speaks for itself by staying with a company for over 49 years. I am currently enrolled and taking a course in Medical Billing and Coding. I hope to finish in January and be able to take the CPC exam in February. Thank you for the time and consideration for thinking of me in this position. I hope to hear from you in the near future.
During the course of the 49 years with the Medicare Program, the following companies have been Medicare’s Contractor:
Equitable Life Assurance
Equicor
CIGNA
Blue Cross-Blue Shield and is the present Medicare Contractor
CGS LLC is the company responsible for processing all Medicare claims.
Sincerely,
Dolores Newcomb
Dolores Newcomb
1140 Brittany Park Lane Antioch, Tennessee 37013/ 615-***-****/ ************@*****.***
Degree Date Earned School
High School Diploma-Central High School 1968
Skill and Abilities
My job duties have given me skills and abilities in the following areas:
English Language/Writing
Time Management/ Active Listening
Customer and Personal Service/Complex Problem Solving
Critical Thinking Law and Government of the Medicare Program/ Judgment and Decision Making
Reading Comprehension/Clerical
Employment
I have worked with the Medicare Program for over 49 years.
Appeals Review Analyst for Medicare Part B and DME carrier June 2001-June 2018
Review patient medical records and utilize clinical and regulatory knowledge and skills as well as knowledge of payer requirements to determine why cases are denied and whether an appeal is required.
Review to determine if any additional documentation has been submitted with the appeal.
Utilize all Medicare guidelines, CMS policies, and regulations for Medicare allowance on the procedure(s) denied on the appeal case to determine if the appeal can be overturned.
If the appeal can be overturned process the appeal according to the facts reviewed, process the appeal for payment.
If the appeal remains denied send a letter to the appellant and the beneficiary of the findings in your review. Explain the reason for denial and give all Medicare regulations references.
Claims Processor February 1969 through June 2000
Review Medicare policy to determine coverage.
Incomplete Claims send a letter to the appellant for missing information
Process claims for payment through the data base.
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