Claims Processing and Office Administrator
Resume:
RESUME
TERESA L. DAVIDSON
Columbus, Ohio 43231
Professional Summary
Eleven years of Claims processing
Twenty-seven years of office experience
Ten years of using Microsoft Word and Excel
Certificate in medical billing and coding
Other competencies: data entry, telephone work, faxing and office assistant
Professional Experience
Sedgwick Claims Management Services Hilliard, Ohio 02/01/2021 to present
Title: LOA Coordinator
Approve FMLA claims
Verify eligibility for new claims
Make calls to claimants on denials and approvals
Concero Resources/Sedgewick Hilliard, Ohio 9/14/2020 to 02/01/2021t
Title: LOA Coordinator
Approve FMLA claims
Verify eligibility for new claims
Make calls to claimants on denials and approvals
Anthem Blue Cross Blue Shield, Columbus, Ohio 10/2008-3/2020
Title: Claims Representative III (Correspondence Unit)
Handle complex provider inquiries
Research provider questions on:
oadjustments
ocontract pricing
oall while maintaining a 100% accuracy and proficiency
ocontacting members benefit plan for unresolved inquires that would include appeals, third party reviews and benefits
Title: Claims Representative II
Verifying member, provider information to ensure correct processing of claims
adjusting claims to correct edits and pricing
Zurich Service Corporation, Columbus, Ohio 01/2006 – 02/2007
Title: Data Entry Operator
Entering medical information from UB92 and HCFA forms for
payment.
Entered and verified totals.
Audited claims that were entered by other Data Entry Operators.
Secretary of State of Ohio, Columbus, Ohio 06/1998 – 08/2004
Title: Customer Service Assistant II
Entering and approving corporate filings based on legal criteria
Created, balanced and closed batches of filings
Responded to customer inquiries via telephone and email
Processed and approved UCC filings
Cross-trained to be proficient in all areas and perform as workload and staffing levels dictated
Title: Data Entry Clerk III
Entering data from corporate filings into computerized forms
Readying the batches of filings to go through the approval process and into the system records.
Sage Computer Services Columbus, Ohio 01/1998 – 06/1998
Title: Data Entry Clerk
Entering and verifying various state agency claims while maintain 100% accuracy and proficiency
A Plus Personnel Services Columbus, Ohio 11/1997 – 01/1998
Title: Data Entry Clerk
Termination of old Bureau of Workers Compensation claims.
First Dennison Columbus, Ohio 01/1997 – 11/1997
Title: Payment Entry Clerk
Entering payments for different types of benefit plans.
Balancing each payment to a ledger.
Coding x-rays from various hospitals to be entered for payment.
Office Team Columbus, Ohio 05/1996 – 01/1997
Title: Customer Service Representative
Answering incoming calls from patients for doctor location, general questions about the benefit plans.
Title: Office Assistant
Answering phones, faxing documents, light bookkeeping and filing.
Title: Mail Sorter
Sorting different types of mail and checks to be entered into the system.
Vision Service Plan Columbus, Ohio 11/1990 – 02/1996
Title: Data Entry Operator
Entering and verifying vision insurance claim forms.
Title: Customer Service Representative
Answering complex calls on various types of vision care.
Adjusting claims that were sent in by doctors or patients.
Title: Benefits Processor
Sending vision insurance claims to doctors and patients
Organizing coordination of benefits for patients with multiple plans
Back up for Lead, which consisted of printing reports, making sure statistics were collected and backlog counts were maintained.
4/90 - 11/90 Ohio Department of Health, Columbus, Ohio 04/1990 – 11/1990 (Contract)
Title: Data Entry Operator III
Enter Purchase Requisitions in the IBM system
Logging, and modifying/canceling orders
EDUCATION AND TRAINING:
Everest Institute
Medical Billing and Coding
Franklin University Campus
Caterpillar Inc.’s MVS COBOL
Columbus State Community College
Lotus Training
Bad Kreuznach High School
Bad Kreuznach, Germany
Graduated
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