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senior reimbursement counselor assistant team lead resume example with 11+ years of experience

Jessica
Claire
resumesample@example.com
(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
:
Professional Summary
Seeking to secure a challenging and rewarding position where my skills are effective to their fullest potential and produce continual experience with growth opportunities
Core Qualifications
  • Excellent quantitative reasoning and mathematical aptitude
  • Scrupulous and meticulous habit of keeping track of the transactions
  • Customer service oriented with strong problem solving and analytical skills
  • Good knowledge of health care programs: Medicaid, Medicare and MCO contracts.
  • Effectively used clinical coding systems: ICD9/10, CPT and DRG
  • Fluent in English and Amharic
Education
Salem State University Salem, MA Expected in 2012 Bachelor of Liberal Art : Liberal Arts - GPA :

Liberal Arts

Roxbury Community College Boston, MA Expected in 2009 Associate Degree : Liberal Art Health Science Biology - GPA :

Liberal Art Health Science Biology

Addis Ababa University College of Commerce ADDIS ABABA, Expected in 2007 Associate : Information Technology/Business Information Systems - GPA :

Information Technology/Business Information Systems

Experience
Beaver Run Resort & Conference Center - Senior Reimbursement Counselor/Assistant Team Lead
Breckenridge, CO, 2015 - Current
  • Excellent quantitative reasoning and mathematical aptitude Scrupulous and meticulous habit of keeping track of the transactions Customer service oriented with strong problem solving and analytical skills Good knowledge of health care programs: Medicaid, Medicare and MCO contracts.
  • Effectively used clinical coding systems: ICD9/10, CPT and DRG LANGUAGES: Fluent in English and Amharic Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payers (Medicare, Medicaid, Commercial payer).
  • Researches and resolves any electronic claim denials.
  • Process and submit different claims using of clinical coding systems: (ICD9/10, CPT and DRG ,DME, HCPCS) Resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
  • Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers.
  • Independently analyzes, reports, and communicates any reimbursement trends/delays (e.g.
  • billing denials, claim denials, pricing errors, payments, etc.).
  • Processes any necessary insurance/patient correspondence.
  • Provides all necessary documentation required to expedite payments.
  • This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians.
  • Coordinates with inter-departmental associates to obtain appropriate medical records as they relate to the reimbursement process.
  • Independently and effectively resolves advanced accounts with minimal supervision.
  • Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation.
Cit Group - Front Desk Supervisor
Johnson City, TN, 05/2014 - 2015
  • Assist the Front Office Manager in ensuring the smooth and efficient overall day-to-day operations of the Front Desk including Switchboard.
  • Oversee Bell and Door staff in the absence of their department head.
  • Provide excellent customer service per the standards of the hotel, and assist in situations to ensure customer satisfaction.
  • Ensure department adherence to company policies, procedures and standards to ensure that guest expectations are exceeded.
  • Assist in providing staff with ongoing coaching, training and development.
  • Prepare reports; handle special projects and assignments as required.
Integrated Electrical Services, Inc. - Front Desk Agent /Night Auditor
Duluth, GA, 06/2013 - 05/2014
  • Highly skilled in delivering outstanding service by greeting guests upon arrival, provide information regarding availability, room types and room rates, Assign rooms pertinent to guests' needs and choice Prepare daily revenue, make corrections and adjustments to books, enter all pertinent information into a prescribed bookkeeping system.
  • Balance all revenue and settlement accounts Produced accounts receivable reports for transmittal of credit cards and audit reconciliation Audited and reconciled all financial and statistical reports for Front Desk, Food & Beverage departments and all outlet cashier's receipts
Accenture Contractor Jobs - Teller
Wayne, PA, 2012 - 06/2013
  • Received cash /checks for deposit, verified amounts and examined checks for endorsement
  • Cashed checks and disburses monies after verifying signatures and member's account balances
Salem State College - Office Assistant
City, STATE, 04/2009 - 2011
  • Answer telephones, direct calls and take messages, maintain and update filing, inventory, mailing, and database systems, review files, records, and other documents to obtain information to respond to requests, successfully organized appointments between employees and clients.
EASY-NET TECH - SQL Database Administrator
City, STATE, 08/2007 - 01/2008
  • SQL Server 2012 installation, Patching and Up gradation
  • SSIS, SSRS Installation and Configuration
  • Exported and imported database objects from/to Access database, flat files (text, excel, and CSV files) and MSSQL Server using DTS, SSIS, and BCP
  • Creation of Maintenance plans for Backup and Recovery, Auto ornamentation

Installed, configured and managed SQL server 2008 and 2008R2 in development, test and production environment

Skills

Accounts receivable, Analytical skills, Backup, Balance, billing, Bookkeeping, cashier, Clustering, coaching, contracts, CPT, credit, customer satisfaction, excellent customer service, Customer service, DTS, Database Administrator, databases, Database, documentation, Fluent in English, financial, forms, Front Office, insurance, Access database, excel, SQL Server 2000, SQL Server 7.0/2000, policies, pricing, problem solving, Processes, coding, Shipping, MSSQL, SQL, SQL Server, supervision, Switchboard, phone

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Resume Overview

School Attended

  • Salem State University
  • Roxbury Community College
  • Addis Ababa University College of Commerce

Job Titles Held:

  • Senior Reimbursement Counselor/Assistant Team Lead
  • Front Desk Supervisor
  • Front Desk Agent /Night Auditor
  • Teller
  • Office Assistant
  • SQL Database Administrator

Degrees

  • Bachelor of Liberal Art
  • Associate Degree
  • Associate

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