Customer Service Follow Up
Resume:
JACINTHA CARTER
**** ***** *** **** ** ST LOUIS MO 63136
OBJECTIVE
TO OBTAIN A POSITION AND UTILIZE MY EXPERIENCE I Am a Military Veteran with Accounting skillsI have several years of experience in Medical field since 1989 with skills ineligibility plans Medicare DDE system and Medicare CSNAP for physicians. Familiar with Managed care Plans for Medicare Insurance
Claims Processor, Medical Biller, Collection Rep, Customer Service Skills plus and other Medical Office skills I am experienced with Excel capable of creating a spreadsheet and follow up MS Word a plus. I have experience with EDI system sending claims, verifying eligibility and follow up in EDI system. Worked on Epic, Amysys, AS400, Medicare DDE Part A and other systems within medical management systems.
Capable on preparing Appeal letters if needed.
EXPERIENCE
PYRAMID Consulting CENTENE
Claims Representative 01/10/2022 -01/02/2023
Worked in an high volume 80 or more Claims, Responsible to process medical claims on Medi-cal accounts clearing edits and completing adjudication. Processed over a 100 medical claims per day depending on the requirement, Determination of correct payment and insurance plans. Appealed any denied claims. Responsible to verify eligibility coverage. Reviewed Eligibility and corrected any errors. Prepared Microsoft letters to be submitted to patients. Worked excel spreadsheet for any old claims to be corrected. Experience with updating documentation and receiving emails fir follow up on claims processing.
Capstone Performance Peak Health
MEDICAL Claims Processor
08/2019-01/2020
Had an ability to handle over 100 per day claims, Reviewed claims on a paperless system clearing edits and preparing for adjudication. Group claims And Medicare healthy benefits claims. Ability to clear edits over 100 claims a day. Follow up with mailings letters to insured concerning benefits.
UnitedSurgicalPartners
Patient Account Representative
05/2018- 05/2019
Provided excellent customer service, Handled over 80 accounts per day by Follow up on unpaid surgical claims providing documentation medical records to support the service. Customer service with insurance and patients Appealing claim when necessary. Verification of plan eligibility. Mailing appeal letters to insurance carriers for reconsideration on denied claims.
Optum360UnitedHealthcare
Customer Service Representative
05/2017-05/2018
Handled over 80 accounts per day by Follow up on hospital Dignity Health Claims rebilling posting payments appealing denied Hospital charges. Familiar with Medicare’s system Part Aand B plans hospital Dignity Health Sacramento
MercyHospitalStLouis
Patient Account Representative
07/2012-10/2015
Handled over a 80, Hospital Medicare part A and B follow up of claims Customer service provided to patients on accounts. Completion of spreadsheets for outstanding balances on claims. Posting of medical payments to accounts. Verification of eligibility on patients plans for billing accuracy.
EDUCATION
High School Diploma 1975
Colorado University On-line 2 years (Medical Billing,Coding
2
AWARDS AND ACKNOWLEDGEMENTS
Success in New project completing implementation and production.
Medical Terminology
3
Contact this candidate