Insurance Specialist

Shana DuBois

St. Louis, Missouri

Objective

To obtain a position in the insurance field that will utilize my education, skills and abilities, with a progressive organization looking to maximize revenue.

Work Experience

Senior Insurance Specialist

6/2006 – 10/2008 Micro Systems- Saint Louis, Maryland Heights, Missouri

 Responsible for all insurance balances for multiple physician practices over 45 days old. Duties include payment posting, verification of insurance, appeals and claim corrections. Practice specialties include Cardiology, Ophthalmology, Vascular, Pulmonary, Neurology, Internal Medicine, Rheumatology, General Surgery, and have assisted with others. Workload included claims for 7 offices, with a total of 14 physicians.

Claims Resolution Specialist

8/2002 - 6/2006 Retina & Vitreous Consultants, Saint Louis, Missouri

 Responsible for insurance balances on all claims for a 3 physician, 4 office surgical practice. Duties included payment posting, appeals and follow up on all claims.

Financial Counselor

11/2001 - 8/2002 Des Peres Hospital/Tenet Healthcare, St. Louis, Mo

 Verify Insurance coverage for scheduled surgical visits, including managed care, traditional, medical assistance, Medicare, and workers compensation policies. Counsel patients on the benefits of their individual policies, as well as their financial obligations. Assist discharged patients with insurance and billing issues.

Insurance Collections Specialist

1/1998 - 11/2001 Syndicated Office Systems/Tenet Healthcare, Philadelphia, PA & St Louis, MO

 Maximize the recovery of insurance reimbursement of facility claims over 120 days old, involving ten different hospitals within the Tenet Healthcare organization. Ensure the proper interpretation of managed care contracts and their application to individual claims. Develop and maintain strong relationships with insurance carrier’s claims and provide representatives. Utilization of verbal and written communication with insurance carriers, including formal appeals. Assist and instruct fellow collectors with ongoing training and contract interpretation issues.

Store Manager

5/1994 - 12/1997 Rent -A-Center, ST. Charles, MO

 Managed a mid-sized retail store outside of St. Louis, MO Responsible for all sales, delivery, collections, inventory management, and personnel administration. Preparation of month end reconciliation summaries, utilizing computer generated reports. Assisted in development and training of staff.

Shift Manager

4/1993 - 4/1994 AVIS Rent-A-Car, Seattle, WA

 Assisted in management of daily operations. Responsible for hiring and training of staff responsible for moving vehicles on site to ensure the availability of clean, ready to rent vehicles.

Education

5/1993 Humboldt State University, Arcata, CA

 Bachelor's Degree

 B.A. in Physical Education, with an emphasis in Fitness/Wellness in corporate settings, Minor in Business Administration.

Skills

Skill Name Skill Level Last Used/Experience

 Microsoft Office, Excel, SMS,S Intermediate Currently used/10

Languages

 English (Fluent - Full Knowledge)

Additional Info

A dynamic, energetic college graduate with over ten years of experience in health care billing and reimbursement. Developed skills and knowledge in facility and physician/insurance contract interpretation and application, medical terminology, and patient relations. Proven ability to resolve difficult claims issues and maximize revenue of facility and physician claims. Four years experience in management, three as a store manager in a mid-sized rent-to-own retail store. Expeditious learner with the ability to adapt to new environments and changes. Highly organized and dependable with strong interpersonal and problem-solving abilities. Very customer/patient service orientated, and self motivated and directed.

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