Claims Representative Resume Example Renaissance Dental

CLAIMS REPRESENTATIVE

Summary

CUSTOMER SERVICE An entry-level position in Administrative office setting, with opportunity for advancement while using my seasoned experience in medical office applications. I am a dependable, self-starter, and able to work with minimal supervision.

Skills

benefits, billing,
charts, email, fax,
insurance forms

office equipment, phone, word-processor
Cash handling
Professionals and friendly
Careful and active listener
Multi-tasking

Experience

Claims Representative07/2017 to 09/2017Renaissance DentalIndianapolis, IN

Answered incoming calls from members and providers.
Contacted dental providers for updated info.
Telephoned dental companies about unpaid insurance claims to obtain settlement of claim.
Reviewed claims EOB for accuracy.
Completed reports for further action and returned incomplete claims to providers for additional data.
Processed insurance payments.
Enrolled new members in insurance and explained benefits of plans.

Claims Representative07/2017 to 09/2017Renaissance DentalIndianapolis, IN

Answered incoming calls from members and providers.
Contacted dental providers for updated info.
Telephoned dental companies about unpaid insurance claims to obtain settlement of claim.
Reviewed claims EOB for accuracy.
Completed reports for further action and returned incomplete claims to providers for additional data.
Processed insurance payments.
Enrolled new members in insurance and explained benefits of plans.

Hair Stylist10/2014 to 11/2016Great ClipsIndianapolis, IN

Maintained up-to-date knowledge of store policies regarding payments, returns and exchanges.
Trained new employees quarterly.
Worked as a team member performing cashier duties, product assistance and cleaning.
I perform a broad range of beauty services
cutting hair applying scalp treatments. shampooing, cutting, and styling hair,permanent, hair coloring, and weaving.

Suspended Billing Rep07/2014 to 10/2014SGS Coram CVSIndianapolis, IN

processed orders for specialty feeding supplies
check for insurance eligibility
update patients demographic info
verified that a valid prescription was on file
contacted medical providers for new and update prescriptions

Health Analyst06/2013 to 04/2014HP Smart IT StaffingIndianapolis, IN

Received incoming calls from medicaid and medicare members as well as providers and pharmacies
Advised of active insurance showing on account .
verifying insurance coverage
Received fax and email inquires to have info update
reached out to provider and pharmacies to provide updated info

Patient care Associate10/2012 to 04/2013Express ScriptsIndianapolis, IN

processed orders for specialty life saving medications
update all new demographic info
verified a valid prescription was on file
contacted doctors for update script info
set up new accounts for members
tracked lost orders and resent priority to insure that no doses where missed

Customer Service Rep III11/2011 to 12/2012Finish-line Cooperated OfficeIndianapolis, IN

placed orders for athletic gear
investigated lost item request
tracked packages
sent out returned slips for damaged products
check for return of items and processed refunds or replacements

Claims billing Account processor/ Collector02/2010 to 06/2010Claim-AidIndianapolis, IN

processed faxed and emailed claim denials
investigated Eligibility of insurance
updated processing mistakes and resubmitted claims for payment
reached out to members for co-pays to settle accounts

Insurance Processing Clerk01/2008 to 12/2008AnthemIndianapolis, IN

reviewed insurance applications to ensure that all questions have been answered,
processed premium payments for insurance policy
reinstated lapsed insurance policies to determine automatic reinstatement according to company

Patient Registrar/Patient Service Representative09/2002 to 06/2004Hinesville MedicalHinesville, GA

Carefully reviewed medical records for accuracy and completion as required by insurance companies.
Assigned additional diagnosis codes based on specific clinical findings (laboratory, radiology and, pathology reports as well as clinical studies) support of existing diagnoses
Answered phone and set appointments Scheduled and
confirm patient's diagnostic appointments, surgeries, and medical consultations
Greet visitors, ascertain purpose of visit and directed to appropriate office
Operated office equipment such as voicemail, word-processor, invoices' and medical records
received and routed message
Fowarded documents such as laboratory results to appropriate staff
compile and recorded medical charts, reports and correspondence,
using a personal computer, fax, and email.

Patient Service Representative11/1999 to 07/2002I U Medical GroupIndianapolis, IN

Protected the security of medical records to ensure that confidentiality
maintained reviewed records for completeness, accuracy and compliance with regulations.
Entered data, such as demographics, history and diagnostic procedures and treatment into computer
processed and prepared government forms.
Processed patient admission and discharge documents
pulled and filed medical records
Update patient information for billing
received co-pays and balanced drawer.

Education and Training

High School Diploma: General1987Arlington High schoolIndianapolis, IN, Marion

Certification: Office Administration1997Training IncIndianapolis, IN, MarionMicrosoft ,excel, office procedures people soft outlook

Activities and Honors

graduated valedictorian of training inc

Resume Overview

Companies Worked For:

Renaissance Dental
Great Clips
SGS Coram CVS
HP Smart IT Staffing
Express Scripts
Finish-line Cooperated Office
Claim-Aid
Anthem
Hinesville Medical
I U Medical Group

School Attended

Arlington High school
Training Inc

Job Titles Held:

Claims Representative
Hair Stylist
Suspended Billing Rep
Health Analyst
Patient care Associate
Customer Service Rep III
Claims billing Account processor/ Collector
Insurance Processing Clerk
Patient Registrar/Patient Service Representative
Patient Service Representative

Degrees

High School Diploma : General 1987
Certification : Office Administration 1997

Claims Representative Resume Example

Resume Score: 90%

DISCLAIMER

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