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Insurance Specialist Care Representative

Location:
Minooka, IL, 60447
Salary:
$65,000
Posted:
January 09, 2023

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Resume:

Kelly Polizzi

Experienced Medicare Biller / Customer Care, Insurance Verification

Minooka, IL 60447

aduj84@r.postjobfree.com

815-***-****

• Self-driven and creative; developed and implemented numerous ideas effectively. Proven quantitative results.

• Flexible; welcome and handle progressive levels of responsibility effectively.

• Excellent interpersonal and communication skills.

• Work daily with members, providers, administrators, as well as other third parties to verify benefits and eligibility pwith CPTs, ICD-10 codes, pre-certification/pre-determination, third-party administrators, self-funded trusts with a variety of PPOs including BCBS, Cigna, Aetna Signature Administrator, etc.

• Experienced with Buy & Bill high dollar amount J codes, obtaining J codes through the pharmacy benefits and how to communicate the process to members and providers in an effective manner.

• Experience with billing to Medicare B for enteral feeding, osteomy and catheter supplies. Familiar with Med B regulations and guidelines.

• Extensive experience in several software programs, including Microsoft Office Products (Word, Excel, PowerPoint), 8x8, Lotus Notes, various database programs, etc. Authorized to work in the US for any employer

Work Experience

Customer Care Representative

Christian Brothers Services - Romeoville, IL

January 2020 to Present

Responsibilities include:

• Answering any and all calls that come into a high volume call center independently from my home, as well as with a team of representatives and supervisors connected via a chat and phone system (8x8)

• Follow up independently with providers and members on any open call notes regarding any issues such as questions on claims, pre-certifications, pre-determinations, repricing and all escalated issues.

• Accurately advise claim status, denial reasons, appeal process; ability to identify what may be wrong with a claim to send back to examiner for reprocessing. Receptionist/Medical Billing/Insurance Specialist

Kuhar Vision Care - Plainfield, IL

June 2013 to July 2014

Responsibilities include scheduling appointments, answering phones, patient intake/check-in, verifying insurance eligibility, submission of insurance benefits, work directly with various insurance companies including Blue Cross Blue Shield, United Healthcare and Medicare to resolve medical coding and eligibility issues. Heavy customer contact.

Weekend Secretarial Supervisor

Kirkland & Ellis - Chicago, IL

July 2005 to May 2006

Worked with several high-profile attorneys in order to facilitate heavy workloads on weekend basis;

• Attended staff meetings every Friday in order to successfully coordinate, organize and manage the Secretarial Department as a whole cohesive unit;

• Scheduled all weekend work in advance with secretarial staff; successfully coordinated with secretarial staff for routine incoming, non-scheduled attorney requested work;

• Worked one-on-one with numerous attorneys in a managerial capacity in order to meet critical daily deadlines;

• Supervised legal secretarial staff closely to monitor attorney workload and effectively guarantee that jobs would be finished at a high level of accuracy;

• Effectively communicated with secretarial staff as well as other Legal Secretarial Supervisors in order to effectively communicate any overflow workload and ensure quality control for all attorneys;

• Worked with several evening/weekend secretaries to create a Central Staff Procedure Manual. Word Processor III

KMZ ROSENMAN - Chicago, IL

August 2003 to July 2005

Duties included preparation of complicated documents (input, scan and clean, email conversions, tapes, etc.) in a word processing environment that is both high volume and deadline oriented;

• Worked one-on-one with numerous attorneys in a secretarial capacity in order to meet critical nightly deadlines.

Document Center Operator

VEDDER, PRICE, KAUFMAN & KAMMHOLZ - Chicago, IL

February 2002 to June 2003

Duties included preparation of documents (keys, scans, email conversions, etc.) in a word processing environment that is both high volume and deadline oriented; specialization in aircraft and litigation areas.

• Worked one-on-one with numerous attorneys in a secretarial capacity in order to meet critical nightly deadlines.

Evening Legal Secretary

Land Use Group

July 2000 to February 2002

Served as primary evening support to the Chair of the Group, as well as to all Group attorneys. Duties included preparation of correspondence, travel arrangements, expense reports, organization of attorney's daily deadlines, and meeting critical deadlines daily.

• Served as administrative coordinator for Group's client events, which included the 2001 Billiards outing and the 2002 Cupola Party. Duties included preparation of invitations, coordination with Marketing Department and vendors, as well as administrative support in the coordination of invitees, meet-and- greet duties, etc.

Legal Secretary

JENNER & BLOCK - Chicago, IL

September 1997 to July 2000

Duties included preparation of pleadings, briefs, complaints and other court documents for Senior Partner and Associates; travel arrangements; machine transcription; extensive client contact, and special projects as assigned.

• Served as project coordinator to the Asian Development Bank (ADB) Annual Meeting; travel and meeting arrangements for the Ambassador and Executive Director of the ADB; coordinated cocktail reception in honor of the Ambassador; served as liaison to coordinate sponsorship between Jenner & Block and CNA. Evening Legal Secretary

BELL, BOYD & LLOYD - Chicago, IL

March 1996 to August 1997

Duties included preparation of documents (POS, OS, UCC Statements), heavy revisions to documents, proofreading, pulling cases and meeting critical deadlines daily.

• Oversaw fax and switchboard departments.

Legal Secretary

Labor & Litigation

September 1994 to March 1996

Duties included preparation of pleadings, briefs, complaints and other court documents for Senior Associate; travel arrangements; machine transcription, pulling cases and meeting critical deadlines daily. Sr. Administrative Assistant

AMOCO CORPORATION - Chicago, IL

October 1991 to October 1994

Directed the development of the shareholders meeting Question & Answer book for the CEO.

• Administered updates on the state statistical database.

• Coordinated meeting and catering arrangements for as many as 200 attendees in preparation for several meetings both on-site and off-site.

• Received recognition award from my peers for excellence in superior client service, exceptional effort and teamwork.

Education

1 year completed in Liberal Arts

University of Illinois at Chicago - Chicago, IL

1996 to 1997

Fox College

September 1991

Skills

• Typing speed 80+ wpm, shorthand, database entry and management (10+ years)

• Live Chat (3 years)

• Medical Coding (7 years)

• Proofreading (10+ years)

• Medical Billing (7 years)

• Transcription (10+ years)

• CPT Coding

• Insurance Verification

• Word Processing

• Medical Records

• Medical Office Experience

• Project Coordination

• EMR Systems

• ICD-10

• Administrative Experience

• Data Entry

• HIPAA

• Medical Terminology

• ICD-9

• Medical Scheduling

• Phone Etiquette

• Personal Assistant Experience

• Quality Assurance

• Anatomy Knowledge

• Microsoft Powerpoint

• Negotiation

• Physiology knowledge

Assessments

Protecting patient privacy — Proficient

October 2021

Understanding privacy rules and regulations associated with patient records Full results: Proficient

Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.



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