Customer Service Insurance

Rene Masterson

***** ******* ***** ***. ***. A

Baton Rouge, LA 70818

225-***-****-cell

***********@*****.***

Education:

Bachelors Degree - Health Care Management-Austin Peay University-1996

Associate Science Degree’s- Math & Science Victor Valley College-1992

Certification-Certified Occupational Safety Specialist-Louisiana State University-2012

OSHA 10 Hour card-Construction & General Industry-2012

Employment History:

Fresenius Dialysis- 9/6/2011 –12/30/11 Baton Rouge, LA.(Temporary Position)

• Process admissions for dialysis patients within the United States and Internationally.

• Interface with hospital to admit patients into Fresenius clinics(discharge planners, social worker etc).

• Process request for patient wanting to travel within the U.S and abroad.

• Ensure that all necessary documentation was obtained prior to travel, admissions or transfers.

Bay Area Rehabilitation Center - 5/12/-2005-09/30/2009/-Baytown, TX

• Entered PT, OT, Speech and DME billing charges for commercial Medicare and self pay payers.

• Submitted paper and electronic claims for payment.

• Provided complete follow up and correction (coding) of claims.

• Generated billing reports to the CFO directly.

• Processed appeals online & paper and through phone conversations with insurance companies.

• Set up payment plans for patients and addressed billing question from insurance companies and patients.

• Prepared bank deposits and other administrative support duties as needed.

Vanderbilt University - 12/05/2001-12/30/2003-Nashville, TN

• Submitted Medicare claims electronically for clinic specialty charges and hospital fees.

• Maintained follow up of 40+ claims daily.

• Addressed billing questions from patients and insurance companies.

• Entered patient information, insurance information and corrections.

• Processed Medicare appeals and other billing problems.

• Participated in audits and special billing projects within our department.

Renal Care Group - 12/03/1998-12/31/2000/Nashville, TN

• Received and submitted renal billing charges electronically.

• Set up and maintained insurance demographics in the computer.

• Maintained a high volume of calls to insurance companies for follow up of Medicare & Medicaid payments as well as addressing patient questions.

• Prepared start up charts for contracted companies new patients.

• Provided new employees with billing software training and set up.

• Performed payment audits and customer service product tracking.

• Participated in special billing projects as called for as well as general office support duties.

Watson Wellness Center - 01/05/1996- 11/02/1998-Oakland, CA

• Supervised a staff of eight employees in an out-patient clinic setting.

• Managed front and back office operations for a clinic of four doctors.

• Maintained doctor and facility credentialing.

• Ordered all office and medical supplies.

• Conducted all interviews and set up of new employee's.

• Ensured proper maintenance of office equipment.

• Provided software update training for employees.

• Performed separate billing for a contracted Chiropractor.

• Assisted in the development of health fairs and screenings.

• Help to ensure that the mobile van was stocked with needed medical/office supplies for prostrate screenings.

• Submitted billing reports to the doctor and other support duties as needed daily.

• Provided back up to front and back office duties as needed.

Personal Attributes:

• Management experience.

• Effective communicator.

• Knowledge of CFR 1910 & 1926 standards.

• Ability to evaluate problems and develop resolutions to them.

• Willingness to learn new skills.

• Experience in training and development.

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