Claims Specialist Accounts Receivable
Resume:
T A M A R A N E R E S T A N T
ZIONSVILLE, IN
********@*****.***
PROFILE
Experienced in insurance billing and claims processing using platforms such as Seacoast, Eclinical, Waystar, Availity, Zoll, and RescueNet Dispatch Software. Completed a comprehensive Health Claims Specialist training program, including classroom instruction, hands-on computer billing, and a health claims externship. Skilled in managing accounts receivable, collections, and navigating the complexities of insurance reimbursement.
RELEVANT EXPERIENCE
Medical Biller 2024- Present
Priority Ambulance LLC, Indianapolis 2024- Present
• Navigate through Waystar and Availity for insurance eligibility and claims status
• Called insurance for denied claims and reconsideration
• Working credit balances aging
• Taking payment from the patient and updating the account or provided payment plan
• Updated the corresponding received to the patient account or the insurance company
Alert Ambulance Service Inc., Fall River 2019-2021
• Navigate through the insurance portal to verify patients’ eligibility
• Billing insurance to CMS 1500 Form
• Interpreted EOB and billed secondary insurance or the responsible party
• Collecting payment from the patient
• Called insurance for review and reprocessing claims for reconsideration
• Call the Nursing Home to verify if a patient is skilled (Med A) or not to bill insurance
US-Laboratories, Taunton 2016-2019
• Enter patient info such as insurance information, patient demographics
• Handle client telephone calls, such as transfers or corrections
• Month-end billing for clients or insurance companies
• Call the Facility for past due and collections again
• Check patient insurance via Passport for eligibility
• Knowledge of Microsoft, Excel, and Outlook
• Posting payment
• Great customer service skills
• Patient and teamwork experience
• Reconcile the client’s account
• Monitoring client payment
Education
The Salter School, Fall River, MA, Graduated 2016
Health Claims Specialist Certificate; GPA:3.84/4.0 Relevant coursework
• CPT, ICD-10-CM, HCPCSD, Coding
• Microsoft Office: Word/Excel
• HIPAA Compliance: Medicare, Medicaid
• Medical Law and Ethics
• Office Procedures
Skills
• Management
• Problem solving
• Communication
• Leadership
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