Medical Insurance
Resume:
Elaine Carroll
Portland, OR 97206
***************@*****.***
Objective: I am interested in a position which will give me practical experience as a paralegal. Ultimately, I am interested in a position in which my experience and knowledge in both the healthcare and legal fields can be an asset.
Education: Associate of Applied Sciences Degree in Healthcare Administration; Pioneer Pacific College, Clackamas Or. Graduated April, 2010.
Paralegal Associate of Applied Sciences Degree; graduated January, 2012.
Certification: Insurance and Coding Specialist. Certified February 2010. National Center for Competency Testing.
Relevant Course Work:
Healthcare: Legal:
• ICD-9, CPT, and HCPCS Business Law
• HIPAA Compliance Training Course Domestic Relations/Family Law
• Billing and Coding Decedents Estate and Probate Law
• Health Information Management Legal Research and Writing
• Medical Law and Ethics Civil Procedure and Documentation
• MS Office Suite Torts / Legal Law and Ethics
• Quickbooks Criminal Law
• Medisoft and The Medical Manager Constitutional Law
Work Experience:
Laidlaw & Laidlaw, PC. West Linn October 2011-January 2012
Internship
Answer telephones, greet clients and vendors.
Maintain filing
Prepare documents for mailing; apply postage
Complete research projects assigned by attorneys
Apria Healthcare Portland October 2006-March 2008
Customer Quality Specialist
Verify insurance eligibility and benefits, by telephone or internet.
Obtain verbal/written authorization for medical equipment/supplies and documentation of medical necessity from appropriate sources, as required by law and insurance criteria.
Verify/confirm medical necessity through analysis of diagnosis and documentation
Contact patient to advise of order placement, confirm all demographic information. Communicate financial responsibilities and/or additional information as necessary to process order to completion.
Back-up receptionist; answer seven-line phone system and greet customers and vendors.
Providence Home Services Portland May 2000-June 2006
Revenue Analyst Representative
Confirm patient meets medical criteria for equipment ordered per their insurance policy, and verify the equipment delivered was what was ordered.
Verify that proper signature requirements have been met upon delivery confirmation.
Obtain and verify any required prior authorizations.
Obtain any medical necessity documentation required per the involved insurance company(ies), particularly the government payers: Medicare and Medicaid.
Release order for revenue process upon completion of documentation approval.
Contact this candidate