Customer Service Medical Claims

JOSEPH W. DIPALERMO

**-** ******** ****, **********, NY 11779

************@***.*** 631-***-****

PROFESSIONAL EXPERIENCE

HealthSmart-Hauppauge, NY 2/16-Present

Senior Claims Examiner/Trainer/Collector

Handle corrected claims and process adjustments

Train and mentor new hires

Monitor accounts on daily basis

Investigate historical data for debts and ills

Contacting Hospitals to collect on high dollar accounts

ADMINISTATIVE SERVICES ONLY-Lynbrook, NY 7/12-10/15

Medical Claims Processor/Customer Service

Processed Medicare Supplemental claims

Handled all claims to be adjusted

Spoke with providers and members regarding claim inquiries

EMBLEM HEALTH PLAN- MELVILLE, NY 1/08-12/10

Medical Claims Collector/Customer Service

Processed facility and professional claims

Call providers and hospitals to collect on past due bills

Processed Medicare claims using automated systems, following all established government guidelines and procedures

Adjust claims processed in error

Worked closely with collection agencies

ATLANTIS HEALTH PLAN- NY, NY 5/07-1/08

Claims Examiner

Processed hospital and major medical claims

Handled correspondence from participants and providers

Sole maintenance of electronic provider files

Issued payments and/or requesting refunds where applicable

Liaison between Claims Department and Participant Services

MAHARAM- HAUPPAUGE, NY 2/05-4/07

Accounts Payable Analyst/Accounts Receivable Analyst

Processed daily cash receipts and made bank deposits.

Posted receivables to electronic spreadsheet.

Coordinated with the credit department to resolve problems on various accounts.

Responsible for filing, sorting mail and served as a backup for Accounts payable.

Responsible for posting all foreign textile orders

AFTRA- NY, NY 5/99-8/04

Senior Claims Examiner

Processing of hospital and major medical claims (including re-pricing)

Processed medicare claims using automated systems, following all established government guidelines

High-dollar claims

Processing EDI (electronic data interchange) and RDE (rapid data entry) claims

Knowledge of CPT (current procedural terminology) and ICD international classification of diseases) codes

BANK OF NEW YORK, VALLEY STREAM, NY 9/93-5/99

Check Processor Supervisor

Processed high volume of checks for various accounts.

Scheduled, trained, and supervised 6 employees.

Resolved customer complaints/disputes in a professional, efficient, and diplomatic manner.

Developed a productivity incentive to increase the number of checks processed leading to greater employee productivity and a decrease in backlog.

EDUCATION:

Nassau Community College, Garden City, NY

A.A.S. Degree, Business Management and Accounting

Queens College, Queens, NY

Completed several Accounting and Liberal Arts courses.

New York School of Career Applied Studies, NY, NY

Certificate in Medical Coding and Billing

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