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enrollment specialists resume example with 17+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
  • :
Experience
Enrollment Specialists, 11/2017 - Present
Innovage Sacramento, CA,
  • Responsible to all areas of enrollment Researching all inquiries for members, employer and eligibility Provide quality service and customer satisfaction Data Entry of Individual plans Processing Daily Reports for members plans Responsible for Quality and Accuracy of work.
Members Service Agent, 12/2016 - 03/2018
Amerisourcebergen Corporation - Corporate Round Rock, TX,
  • Provide explanation of health plan benefits, claims processes, eligibility, and enrollment.
  • Resolve simple to complex problems for members, Reviewing claims paid and denied.
  • Responsible for responding to current or potential members in a timely, professional, and courteous manner.
  • Receiving inbound calls from current members and potential members.
Medical Records Technician, 07/2015 - 11/2016
Innovage Philadelphia, PA,
  • Processing medical records request from providers, Disability request, patient request.
  • Helping patients with medical records request.
  • Answering multiple phone lines.
  • Retrieving Charts from storage.
Medical Records Technician/Claims Technician, 01/1 - 01/1
Children's Hospital Of The King's Daughters Various Locations, VA,
  • Screens initial claims for benefits, analyzes claims and determines disposition.
  • Request exams through Veteran Affairs systems, Retrieving Private medical records from facilities, Processing and Making follow up call on medical records release of information.
  • Utilizes software systems to perform job, CAPRI, DPRIS, PIES, SHARE,VISTA and WORD.
  • Evaluates facts and evidence, Request internal medical records through VA system.
Benefits Verification Specialist, 11/2013 - 01/2014
Aerotek/Lash Group City, STATE,
  • Contact insurance companies, public payers on behalf of the physician's office to verify patient's benefits.
  • Excellent investigative and negotiation skills, Complied with policies, procedures, safety rules and regulations.
  • Performed related duties assigned.
  • Obtaining Authorization for patients visits, procedures, Medication for Remicade, Reviewing claims for processing.
Fiscal Billing Technician, 09/2012 - 07/2013
Peninsula Institute For Community Health City, STATE,
  • Processing claims electronically and paper claims.
  • Review encounter forms to ensure proper coding and submit electronically to Health Services.
  • Researching claims denials, verifying insurance information, perform the billing, follow up and collections, contact various accounts payable offices responsible for the payment of these accounts to query the account status, applying appreciate write offs on accounts.
  • Knowledge of HCFA 1500, UB's 92, ICD9 and CPT coding, Posting payments, 151 adjustments.
Medical Records ROI Specialist II, 09/2010 - 01/2012
Health Port Inc City, STATE,
  • Processing Medical Records Releases, Subpoena Duces Tecum, Processing Witness Subpoenas, Data Entry, taking Request from Physician's office and faxing over documents requested.
  • Helping Walk in Customers, Answering multiple phone lines.
Medical Records Technician, 10/2008 - 08/2010
Cardiology Consultants City, STATE,
  • Pre Authorization for testing with ICD-9 codes and CPT codes, matching encounter forms with patient charts.
  • Scheduling Appointments, Prepping Charts for Doctor's Appointment, and Obtaining test results for patients and doctors, Filing and Pulling charts and Purging charts.
Patient Registration Associate, 10/2007 - 10/2008
Virginia Beach Ambulatory Surgery Center City, STATE,
  • Interviewing patients for registration for outpatient surgery appointments, answering multiple telephones lines.
  • transferring calls to the approach departments, enter and verify that all patient demographics and billing information correctly entered/verified at time of check in, Processing claims to submit for payment,.
  • Assisting patients with Insurance and billing questions.
Pre Authorization Assistant, 04/2007 - 10/2007
Amerigroup Corporation City, STATE,
  • Assisting Physician's office with obtaining authorization for diagnosed testing and procedures done in the office.
  • Received calls from and members with medical insurance coverage Amerigroup Corp, advised members and providers of participating providers and facilities, Discussed member-specific plan benefits to the member understands.
Supervisor Medical Records, 02/2002 - 03/2007
Virginia Oncology Associates City, STATE,
  • Supervision of 12-15 Medical Records Techs, Analyzing and disseminating patient information and clinical data making it patient health record, Distribute and balance workload among personnel within the department, Handling and Resolving Medical Records Issues with patients and providers within medical records department, Strong decision making and problem solving skills.
Education
Diploma: , Expected in
-
Tidewater Community College - Virginia Beach, VA
GPA:
Status -
Medical Billing and Coding Specialist August 4, 2016: , Expected in
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- ,
GPA:
Status -
Summary
Dedicated, experienced professional with training in medical records, medical billing and coding, medical terminology, and ICD-9-CM coding. Strong organizational, communication, and project management skills., cooperative team leader, and proven multi-tasking operations support skills.
Skills
accounts payable, Scheduling Appointments, approach, balance, benefits, billing, Charts, CPT coding, CPT, customer satisfaction, Data Entry, decision making, faxing, Filing, forms, ICD-9, Insurance, Assisting Physician, Medical Billing, office, WORD, negotiation, Assisting patients, personnel, policies, problem solving skills, processes, Coding, Quality, Receiving, Researching, safety, Supervision, surgery, telephones, phone, VISTA

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Resume Overview

School Attended

  • Tidewater Community College

Job Titles Held:

  • Enrollment Specialists
  • Members Service Agent
  • Medical Records Technician
  • Medical Records Technician/Claims Technician
  • Benefits Verification Specialist
  • Fiscal Billing Technician
  • Medical Records ROI Specialist II
  • Medical Records Technician
  • Patient Registration Associate
  • Pre Authorization Assistant
  • Supervisor Medical Records

Degrees

  • Diploma
  • Medical Billing and Coding Specialist August 4, 2016

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