Workers Compensation Worker's
Resume:
Tamika Rogers
Adjuster
Dallas-Fort Worth, TX
***********@*****.***
Professional Summary
Skill Set
• ALL LINES ADJUSTER TX,OK,LA,and AR
• STATE FARM CERTIFIED
• Settlement Experience
• Worker's Compensation
• Setting of Reserves
• Medical Billing
• Collections/EOB’s
• Accounts Receivables
• ICD-9/ICD-10 CPT Codes
• CMS-1500/UB-04
• Commercial/WC Insurance
• Medicare/Medicaid
• Benefits Verifications
• Denials/ Appeals
• Data Entry/Prior Authorization
• Analysis/Medical Contracts
• Workers Compensation rules/Follow-up
• CCI Edits
Authorized to work in the US for any employer
Work Experience
Workers Compensation Claims Adjuster
Gallagher Bassett-Remote
November 2023 to November 2024
1. Set up/Follow up with claimants,Clients and doctors by emailing, faxing or phone call 2. Pay medial Bills,claimants
3. Update compensable injury and Reserves
4. Give authorization for treatment
5. WRITE DENIAL LETTER
6. Send Closure Letter
7. Close Claims
Closing Adjuster
Jonas Group/Gallagher Basset
June 2023 to October 2023
Closing all worker's compensation claims requesting SIF on all Washington claims. Sending out proper letters to insure claims process correctly. Send all bills to process. Workers Compensation Claims Adjuster
Sedgwick-Dallas, TX
November 2021 to April 2023
Handle claims from the beginning to the end
1. Set up/Follow up with claimants,Clients and doctors by emailing, faxing or phone call 2. Pay medial Bills,claimants
3. Update compensable injury and Reserves
4. Give authorization for treatment
5. WRITE DENIAL LETTER
6. Send Closure Letter
7. Close Claims
Account Manager
Advanced Infusion Solutions-Dallas-Fort Worth, TX
June 2020 to May 2021
• Work follow-up for all Insurance/Correspondence
• Make out outbound collection calls and receive patient calls to make payment
• Work appeals for all major Commercial Carriers
• Submit claims for electronic billing
• Send out statement to patients
Account Rep
Conifer-Dallas-Fort Worth, TX
January 2020 to June 2020
• Work follow-up for all Insurance/Correspondence
• Make out outbound collection calls and receive patient calls to make payment
• Work appeals for all major Commercial Carriers
• Submit claims for electronic billing
• Send out statement to patients
99 MANAGEMENT/REBA
Account Manager
Work follow-up for all Insurance
November 2018 to October 2019
Correspondence
• Make out outbound collection calls and receive patient calls to make payment
• Work appeals for all major Commercial Carriers
• Submit claims for electronic billing
• Send out statement to patients
AR Specialist
ADDISON GROUP
July 2018 to October 2018
• Work follow-up for Commercial and Workers comp Insurance
• Make out outbound collection calls
• Write Appeals if needed for payment
• Verify contracts on file for Workers Compensation claims
• Work appeals for all major Commercial Carriers
• Verify Prior Authorizations
• Speak to Workers Comp Adjusters verifying patient's compensable injury Obgyn and Endoscopy ACCOUNT MANAGER
ORTHOECONOMICS
September 2017 to June 2018
• Work follow-up for al Insurance
• Make out outbound collection calls and receive patient calls to make payment
• Work appeals for all major Commercial Carriers
• Submit claims for electronic billing
• Work all corrections when claims reject electronically
• Correct CPT coding on rejections
AR Specialist
MED PRO
November 2015 to March 2017
• Work follow-up for Workers comp Insurance
• Make out outbound collection calls
• Write Appeals if needed for payment
• Work appeals for all major Commercial Carriers
• Verify Prior Authorizations
CERGIS BILLING
AR Specialist
Commercial and Workers comp Insurance
February 2015 to November 2015
• Work follow-up for Commercial and Workers comp Insurance
• Make out outbound collection calls
• Write Appeals if needed for payment
• Work appeals for all major Commercial Carriers
• Verify Prior Authorizations
• Training for ICD-10
AR Specialist
ADDISON GROUP
May 2014 to February 2015
• Work follow-up for Commercial and Workers comp Insurance
• Make out outbound collection calls
• Write Appeals if needed for payment
• Verify contracts on file for Workers Compensation claims
• Work appeals for all major Commercial Carriers
• Verify Prior Authorizations
• Speak to Workers Comp Adjusters verifying patients compensable injury Workers Comp Accounts Receivable Specialist
PINNACLE ANESTHESIA
August 2008 to July 2013
• Billed out new claims, sending them electronic, mailing or faxing
• Worked follow up via telephone with Workers Comp Insurance Companies
• Address electronic claim denials & re-file as appropriate
• Follow up on claims by faxing or mailing appeals or calling Insurance Carriers
• Worked all workers compensation account, verifying accounts with the adjusters
• Handle patient demographics for all Workers Comp claims
• Make outbound collection calls to insurance carrier
• Verified benefits with over insurance carries, including Medicare, Medicaid, Aetna, BCBS, United Healthcare, Secure Horizons, Amerigroup, Molina, Humana, and Tri Care Nursing Home and Hospital Patient Registration Clerk MEDICAL EDGE HEALTHCARE GROUP
August 2007 to June 2008
• Worked with a team responsible for entering patients information
• Verifying insurance for numerous payers via website or phone
• Making phone calls to appropriate insurance companies to follow up on patient insurance
• Verified Workers Comp Claims and Nursing Home Hospital patients
• Verified benefits with over insurance carries, including Medicare, Medicaid, Aetna, BCBS, United Healthcare, Secure Horizons, Amerigroup, Molina, Humana, and TriCare Sales Associate
WALMART
April 2002 to June 2005
• Cashier, stocker and team player
• Worked in many different areas from cashier, stocked the shelves, and worked in the deli Education
High school diploma in Medical Billing and Coding Program Sanford-Brown Institute
Skills
• ALL LINES ADJUSTER
• Accounts Receivables
• Medical terminology
• Medical collection
• CPT coding
• Epic
• Vision on Demand
• Accounts receivable
• Medical Scheduling
• Centricity
• Hospital Experience
• Typing
• MD Suites
• Medical Office Experience
• Medical Terminology
• Managed care
• Cerner
• Account Management
• Basic math
• CCI Edits MediSoft
• Anatomy Knowledge
• Management
• Medical Billing
• ICD-9/ICD-10 CPT Codes
• Denials/ Appeals
• Commercial/WC Insurance
• Physiology Knowledge
• Medicare/Medicaid
• IDX
• Fusion Ris
• Supervising experience
• Data Entry/Prior Authorization
• Medical Records
• CMS-1500/UB-04
• Collections/EOB's
• Workers Compensation rules/Follow-up
• HIPAA
• Customer service
• Primary care
• ICD-9
• Availity
• Analysis skills
• Analysis/Medical Contracts
• Insurance Verification
• Benefits Verifications
• ICD Coding
• Laboratory Experience
• Microsoft Office
• Workers' compensation
• Account reconciliation
• Pediatrics
• Medical Coding
• EMR Systems
• QuickBooks
Certifications and Licenses
Adjuster
February 2018 to Present
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