Health Insurance Claims & Billing Specialist
Resume:
CYNTHIA WALKER
.
EXPERIENCE
Twenty-seven years of adjusting, processing health insurance claims and customer service and office management.
CHC SOLUTIONS
(2022-2025)
OFFICE COORDINATOR
oExperience improving office efficiency by implementing streamline processes and enhancing communication.
A/R BILLING ASSOCIATE
oFollowed current workflow processes to ensure claims were correctly billed in a timely manner.
DOCUMENTATION SPECIALIST
oMaintained a high level of professionalism to provide excellent customer service during all communications with customers and vendors.
oFollowed current workflow process to ensure timely follow up on assigned accounts.
oContacted patients, physician’s offices, and internal resources to obtain information and documentation needed for insurance billing.
oPerformed research to identified documentation errors or issues and brought them to resolution.
oFollowed up on outstanding documentation that had not been received until it was returned and the order was billable.
oWorked with customers and the company sales team to resolve account issues as needed.
oComplied with all applicable payment policies, procedures, and patient protocols. Complied with all current government regulations and professional standards, including voluntary compliance plans.
BLUE CROSS BLUE SHIELD
(1995-2022)
SENIOR RESEARCH EXPERT
oAdjusted claim overpayments. Completed check vouchers for providers and members.
oApplied the Payment Reduction system to relieve overpayments.
oAdjusted claims, Completed daily reports for groups with performance guarantees.
oUpdated and worked coordination of benefits for BCBS members in accordance with multiple insurances.
oWorked under Medicare for two years.
oWorked with new hires to learn and train on the job.
CUSTOMER SERVICE ASSOCIATE
oAnswered questions about benefits, member's eligibility, billing, lifetime max, copay, coinsurance, and deductibles.
oProcessed claims and payment extension service requests.
oWorked with members, brokers, representatives from doctors to recover patient information.
CONTACT
***************@*****.***
5432 Dupont Street
Chattanooga, TN 37412
EDUCATION
High School Diploma
1986 Graduated with Honors
Cupbearer Ministry Church
SKILLS
Microsoft Word
Microsoft Excel
Google Suites
Communication
Problem-Solving
Teamwork
REFERENCES
Karla Slaugenhaupt
Team Lead at CHC Solutions
Carlene Moon
Former BCBS Supervisor
Jamie Walker
Blue Cross Blue Shield
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