Financial counselor
Resume:
Natisha Gaston
*************@*****.***
EDUCATION
Don Bosco Charter High School Graduated May 2004
SOFTWARE EXPERIENCE
Microsoft Word, Excel, Data entry, Care Radius, Facets, medical terminology, knowledge of ICD-10 and CPT codes.
PROFESSIONAL EXPERIENCE
Olathe Medical Center
August 2022- Present
Insurance Financial Counselor
●Medical claim review
●Review medical documentation
●Compare medical billing with authorized services.
●Review ICD 10 codes, CPT codes
●Review coding
●File appeals
●Document
●View and work with UB04s forms
●Correct medical claims
●Send corrected claims
●Call insurance companies to verify eligibility
●Assist patients with billing questions
Research Medical Center
November 2021-August 2022
Registration Lead
●Greet patients
●Check insurance eligibility
●Cover shifts that are not covered
●Educate patient with patient rights
●Register patients in appropriate and timely manner
●Give patient resources with no in’s coverage
University of Kansas Health System
APRIL 2019- November 2020
PSR
●Check patient in for appointment
●Schedule patient appointment
●Check insurance eligibility
●Check patient out
●Reschedule appointments
Encompass Medical Group
October 2017- April 2019
Billing Insurance Clerk
●Medical claim review
●Review medical documentation
●Compare medical billing with authorized services.
●Review ICD 10 codes, CPT codes
●Review coding
●File appeals
●Document
●Viewed and worked with HCFA 1500 and UB04s forms
●Correct medical claims
●Send corrected claims
●Call insurance companies to verify eligibility
Triwest March 2016 - April 2017
Medical review billing specialist
● Review medical documentation
● Compare medical billing with authorized services.
● Review ICD 10 codes, CPT codes
● Review coding
● Approve and deny appeals
● Reprocess claims in Facets program
● Document
● Viewed and worked with HCFA 1500 and UB04s forms
Cigna
Customer service Rep September 2015 - January 2016
● Taking inbound calls for customers
● Placing pharmacy mail order for customer
● Provide information about products services or obtain details of complaints
● Explain and provide benefit and eligibility information.
United Healthcare
Provider Services September 2014 - September 2015
● Taking inbound calls for United Healthcare Medicare and Medicaid providers.
● Dealing with medical and RX claims, benefits, billing, eligibility, etc.
● Provider would call in to check status of claims.
● Relay coding issues and errors to provider.
● Viewed and worked with HCFA 1500 forms UB04s.
● Resolve provider service or billing complaints by performing activities such as having claims sent back for reprocessing
Aetna May 2014 - September 2014
Customer Service Rep
● Taking inbound calls.
● Assisting members with setting up transportation for medical appointments.
● Entering data for new Enrollees.
● Dealing with Rx claims on a daily basis.
● Resolved customer service complaints by performing activities such as documenting complaints and sending complaints to proper department.
CVS Caremark September 2013 - March 2014
Customer Service Rep
● Taking inbound calls all day.
● Ordered maintenance medication for members over the phone for mail order.
● Provide information about products and services or to obtain details of complaints.
● Contacted doctors’ offices to assist patient with getting renewals and new prescriptions
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