Absence Management Specialist
Resume:
Lisa Collins
Carnegie, PA ****6
Objective: To obtain a position within the healthcare industry to utilize my background in claims processing and billing as well as customer service. Experience
August 2016-Present UPMC Health Plan
Disability Specialist
Process Disability claim for UPMC employees. Call employees and discuss claim options. February 2006-August 2016 Cigna Group Operations, Pittsburgh, PA Group Claims Analyst (Claim Manager III)
My responsibility is to review and process Short Term Disability claims in a timely manner, usually within 5 business days. Over the past few months I have increased my productivity and meeting my expected decisions per day I am also responsible for communicating with claimants as needed.
January – April 2008-2022
Jackson Hewitt Tax Service, Pittsburgh, PA (Seasonal Work) Tax Preparer
I am responsible for processing Federal, State, and Local Income Tax returns in a timely and efficient manner.
September 2005-February 2006 UPMC Health Plan, Pittsburgh, PA Enrollment Specialist-Government Programs
Working on sending files to CMS to approve for member coverage Called members to verify information on applications Worked on special projects
April 2004-August 2005 UPCI Cancer Services Pittsburgh, PA Collections Specialist
Working self pay and insurance accounts receivable Making sure claims were paid by insurances in a timely manner Reviewing insurance denials and sending out corrected claims Answering patient questions about their account balances February 2003-April 2004 UPMC Physician Services Pittsburgh, PA Customer Service Representative II
Assisted department supervisors with everyday assigned tasks; acting as a team lead. I assisted customer service reps with difficult calls and accounts when supervisors are not available. Able to do adjustments on accounts, coding reviews, merge, split accounts and also void and repost charges as needed.
May 2002-February 2003 UPMC Community Medicine Pittsburgh, PA Customer Service Representative I
Responsible for taking incoming calls from patients or insurance companies Submitted claims to Primary, Secondary or Tertiary Insurances I also corrected billing errors, also following up on claim status.
June 2001-May 2002 University of Pittsburgh Physicians Pittsburgh, PA Customer Service Representative I
Assisted department supervisors with everyday assigned tasks Assisted customer service rep I with difficult calls and accounts Able to do adjustments on accounts
July 2000-June 2001 UPMC Health Plan Pittsburgh, PA Provider Service Representative
Responsible for taking incoming calls from doctor’s offices checking on claim status, member eligibility or benefits. Also responsible for doing any adjustment necessary to a claim to have it processed correctly.
November 1999-July 2000
Internal Adjuster Research Support
Responsible for investigating and adjusting claims that were processed incorrectly also responsible for tracking problem trends in the processing of claims. February 1999-October 1999 Kondrot, Stout, & Associates Pittsburgh, PA Medical Biller
Responsible for posting charges to patients accounts, posting patient and insurance payments when received, also billing insurance carriers. Responsible for getting patient referrals from insurance companies.
August 1997-February 1999 Advantage Health/Qualmed Pittsburgh, PA Medical Referral Specialist
Responsible for authorizing referrals for office visits or emergency visits Direct contact with medical director on authorizing surgical procedures Education
August 2019 to Present Carlow University, Pittsburgh, PA Human Resource Management
July 1989-May 1990 Bradford Business School Pittsburgh, PA Business Management
I learned all aspects of running a business from payroll, scheduling and coverage for business.
Graduated with GPA of 3.89
References Furnished upon Request
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