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Claim Processor

Location:
Detroit, MI, 48219
Salary:
$29,500 --32,500
Posted:
September 05, 2008

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Resume:

Cynthia Robertson

***** **********

Detroit, MI 48219

313-***-****

313-***-****

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

Objective:

Seeking a position with your company in any capacity as a Claim Processor or Reimbursement Representative, over 8 years experience in client servicing and account receivables. Proven track record of troubleshooting, a team player with excellent communication and organizational skills including written, verbal and interpersonal.

Employment History:

Robert Half International

Southfield, MI

9/07 - 12/07 Billing Clerk

Handle various temporary assignments pertaining to medical billing and collection with home infusion claims, home health care and cash application and payroll processing.

Wright & Filippis

Rochester Hills, MI

03/07 - 08/07 Claim Processor

Process (TPA) Medicare DME claims with policy file and other records to evaluate completeness and validity of claim for payment or denial, track productivity and provides report on weekly basis as required by management.

Coram Infusion Healthcare

Plymouth, MI

02/06 - 10/06 Collection Representative

Research and process all delinquent infusion claims over 30 days to ensure proper reimbursement, process credit balances by refund and/or adjustment. Achieve and maintain department goals in accuracy, productivity and timeliness.

Midwest Health Plan

Dearborn, MI

03/04 - 10/05 Claims Processor

Responsible for independently reviewing and processing Medicaid (HMO) claims for payment or deny within 20 calendar days from receipt, knowledge of ICD-9, CPT-4, UB92 and 1500 forms.

Oakwood Healthcare

Dearborn, MI

2/99 - 9/03 Reimbursement Analyst

Follow up with payers on all outstanding workers compensation claims over 30 days for accuracy reimbursement, billing adjustments, refunds and write-off, report any recurring rejected claims to management for evaluation of impact on timely filing and cash application.

Concentra Medical Centers

Bingham Farms, MI

2/97 - 9/98 Billing Clerk

Analyze weekly financial report to determine A/R status for reimbursement for injury and occupational claims, obtain authorization, referrals and medical records relating to payment or treatment, billing and collection, document all action taken on account in the system.

Education:

Degree-2010

Major: Healthcare Administration

Oakland Community College

Skills and Abilities:

Microsoft - Word, Excel, Outlook -- Billing Software- Web-Denis, Hart, Lawson and Lynx Collect System and Quickbook. Familiar with billing BCBS, Medicaid, Medicare and third party payer and specialty billing, with customer service call centers.

Notes and Other Information:

Salary: $29,500 - $31,500



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