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Medical Brokers Assistant Resume Example

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MEDICAL BROKERS ASSISTANT
Professional Summary
Innovative, customer-oriented healthcare administrator with background in managed, clinic and medical coding. Strong background in quality assurance, claims analysis and management principles and practices.  Highly analytical healthcare management professional combining more than 12 years of work in long term care with proficiency in financial management, leadership and positive clinical outcomes.  Adaptable healthcare administrator accustomed to the integration of new healthcare delivery systems and restructuring of work in an increasingly complex regulatory environment.
Skills
  • Attention to detail
  • Fast learner
  • Multitasker
  • Strong computer skills
  • Eager to learn new things
  • Able to work independently or with a group
  • Strong communication skills
  • Dedicated
Work History
Medical Brokers AssistantInsurance Services, Inc. - Branford, CT12/2014 - Current

  • Responsible for taking incoming calls, resolving employee and employer insurance problems.
  • Call insurance companies and doctors' offices to resolve billing problems and errors.
  • Setting up companies with their insurance policies along with new employee applications.
  • Applying for broker licenses.
  • Assisting in all office functions.
  • Setting up computer database and software.
  • Skillfully developed departmental goals, objectives, standards of performance, policies and procedures.
  • Led the planning and achievement of goals and objectives consistent with the companies mission and philosophy.
Billing ManagerPediatric Eye Care - Guilford, CT02/2009 - 07/2011

  • Responsible for electronic billing, reading billing reports and making any necessary corrections to medical coding and patient insurance information.
  • Posting insurance and patient payments, rebilled denied claims and collected secondary insurance payments.
  • Worked closely with insurance companies to resolve patient problems, retrieved patient benefits, and obtained authorizations.
  • Answered phones, made appointments, identified problems and managed billing staff.
  • Organized the department in accordance with administrative guidelines in order to provide specified services to meet the ACA, legal, organizational and medical staff guidelines.
Billing ManagerAssociated Podiatrist of North Haven - North Haven, CT12/2005 - 12/2008

  • Responsibilities Included: electronic billing, over seeing billing reports and making necessary corrections to medical codes and patient insurance information.
  • Posted insurance and patient payments, researched denied claims and rebilled, submitted secondary insurance payments.
  • Worked closely with insurance companies to resolve patient problems, retrieving patient benefits, and obtaining authorizations.
  • Answered phones, made appointments, identified problems and managed billing staff.
Provider/Member Relations RepresentativeHealth Net - Shelton, CT06/2003 - 02/2005

  • Served as a front line customer service representative for providers, guaranteed proper billing procedures and claim submissions.
  • Research, reconcile and explain all inquiries regarding patient plan policies, CPT4/ICD9, EOB and fee schedule issues.
  • Identify opportunities to improve providers understanding of IPA/HMO/POS/PPO policies and procedures through on-site orientation and education for providers and staff.
  • Receive member telephone inquiries related to claims, medical coverage and plan documentation.
  • Generated daily evaluation and summaries of problem cases requiring additional analysis and resolution.
Provider/Member Relations RepresentativeBenesite - Washington Avenue, North Haven, CT04/2002 - 04/2005

  • Provided telephone support for providers to ensure proper billing procedure, patients plan documentation, procedures for claim submission and questions related to CPT4/ICD9, explanation of benefits and fee schedule issues
  • Responsible for completing the necessary documents to get claims reprocessed as well as following up with the providers and members.
Network EngineerErgonomic Group - Rocky Hill, CT11/2000 - 02/2002

  • Provide desktop support for the administrative staff of Danbury and Bristol hospital.
  • Resolved Desktop productivity, application problems, and network communication problems.
  • Experienced level 1 and level 2 telephone consultations for troubleshooting software and hardware problems.
Education
CPC Certified Medical Biller: Medical BillingBranford Library - Branford, CTCurrent
Bachelor: NursingGateway Community Collage - New Haven, CTCurrent
  • Continuing education in the medical field
  • I'm currently working toward getting my degree in nursing as well as keeping up to date with the new billing rules and regulations.  I'm fascinated with the medical industry and have always been drawn to both the clinical and administrative sides of this field.  I want the ability to assist with treatment as well as assist patients and providers with the rules and regulations of medical billing and coding. 
  • I have learned a lot within the 12 years I've managed providers offices, but I've also learned how to read and understand medical plan documentation from another prospective.  
  • I've had the opportunity to work with a wonderful broker who showed me another side of the medical industry that I had no knowledge of.  I have enjoyed consulting with companies about their medical coverage and learning how to find the right  plan for each different employer.  However, my passion still lyes with medical billing. 
Network Administration Certificate May 2000 Microsoft Self-Based Training: Branford Hall Career Institute -
  • A+ Certified
  • Net+ Certified 
  • Microsoft 2000 MCSE
Skills
Act database, administrative, benefits, billing, hardware, CPT4, customer service, database, filling, insurance, managing, Microsoft Access, Excel, office, 2000, Windows 95, 98, Word, Network Administration, network, policies, coding, reading, Research, desktop support, telephone, Answering phones, troubleshooting
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Resume Overview

Companies Worked For:

  • Insurance Services, Inc.
  • Pediatric Eye Care
  • Associated Podiatrist of North Haven
  • Health Net
  • Benesite
  • Ergonomic Group

School Attended

  • Branford Library
  • Gateway Community Collage
  • Branford Hall Career Institute

Job Titles Held:

  • Medical Brokers Assistant
  • Billing Manager
  • Provider/Member Relations Representative
  • Network Engineer

Degrees

  • CPC Certified Medical Biller : Medical Billing
    Bachelor : Nursing
    Network Administration Certificate May 2000 Microsoft Self-Based Training :

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