Third Party Insurance Specialist
Resume:
Tanya Mitchell
Warren, MI *****
********@*****.***
To obtain a position that will build upon my communication, education, and practical skills as well as allow for future growth.
Authorized to work in the US for any employer
Work Experience
Health Insurance Specialist
InfuSystem - Madison Heights, MI
August 2015 to Present
• Review and verify all insurance plans and confirm patient's eligibility.
• Input data into system to ensure accurate billing for current and future services.
• Send all applicable letters and documents to new accounts.
• Determine the extent of liability for insurance plans, coordination of benefits, and personal responsibility.
• Review, analyze and act upon third party C.O.B. rejection letters to determine primary and/or other insurances.
• Interact with patients and third party insurance companies to secure retroactive insurance coverage.
• Identify billing documentation requirements and then request and coordinate document and reports from appropriate resource areas.
• Maintain status on a daily, weekly and monthly basis of all pending accounts (verification, AOB); review information and take appropriate steps to resolve accounts.
• Review and correct all electronic billing edit reports.
• Interpret and explain insurance information and financial data and resolves billing inquiries.
• Research into accounts, perform appropriate financial transactions and account adjustments to correct problems.
• Explain in a clear and understandable way to the inquiring party after all appropriate action has been taken.
• Contact facilities to obtain current insurance information that was not provided with original paperwork. Billing Specialist
Tenet Healthcare/DMC - Detroit, MI
Present
Claims processor/ Cash Posting Representative
Accretive Health - Warren, MI
January 2011 to August 2015
• Researched, analyzed and brought account balance to final resolution.
• Billed/rebilled UB04 and CMS 1500 claim forms. Posted adjustments on patient accounts, followed-up on claim rejections. Posted credit card payment to proper accounts
• Reviewed all hard copy and electronic claims
Insurance Verifier & Medical Biller
Wright & Filippis - Auburn Hills, MI
February 2008 to December 2010
• Verified patient medical coverage
• Billed Medicaid and Medicaid HMO's claims for payment.
• Processed CMS 1500 forms, rebilled claims for proper payment.
• Miscellaneous assignment such as: scanned inquiries, retrieved EOB's and verified patients Rx for accuracy.
Office Assistant
General Filters Inc - Novi, MI
February 2006 to February 2008
• Managed accounts payable and accounts receivable.
• Filed and performed miscellaneous projects.
• Answered phones and handled customer orders.
Office Manager
Unlimited Solutions Inc - Detroit, MI
January 2000 to July 2006
• Analyzed office operations and procedures, such as typing, billing, bookkeeping
• Prepared payroll, filing and kept requisition of supplies.
• Scheduled appointments and processed invoices and coordinated company activities.
• Maintained payment of records, invoices, accounts payable and accounts receivable
Education
Associate of Applied Science in Healthcare Administration Baker College
Skills
• microsoft office
• Medical billing
Certifications and Licenses
Driver's License
Additional Information
Proficient in all Microsoft applications and able to type 50 WPM. Excellent verbal and written communication skills. Proven ability to multitask while providing friendly and accurate service. Knowledge of multiple payer websites, Champs, Web Denis, and billing cms1500 forms.
Contact this candidate