Sr. Legal Rep Specialist Resume Example UMASS Memorial Medical Center

SR. LEGAL REP SPECIALIST

Professional Summary

To obtain a position capitalizing on the background of Business Administration, Accounting, Operations Management and Finance, in order to contribute to the productivity and profitability of the organization. Action-oriented with strong ability to communicate. Creative professional with extensive project experience from concept to development.

Core Qualifications

Billing & Coding
MS Office (including Word, Excel, PowerPoint, Access and Internet Explorer)
Meditech system Sorien.

Quick learner
Results-oriented
Experienced in production scheduling
Accounts Payable/Receivable
Creative Problem Solving,

Experience

Sr. Legal Rep Specialist09/2011 to 10/2015UMASS Memorial Medical CenterWorcester, MA

Responsible for complying with requests from outside sources for hospital and physician bills.
Accountable for overseeing timely completion of attorney requests for certified copies of their clients' medical bills and subpoena requests.
Coordinating efforts with the Medical Record Department to ensure that Hospital and Medical Group billing departments have received notice of same subpoena.
Completing and returning all certified mail requests within the legally required (10) ten -day of receipt to ensure a current lien remains in force.
Making appropriate FSC (payer) changes in the Hospital and Group billing system to bill health insurers and switching them back to the responsible parties after requesting claims.
Responding to internal requests for hospital claims (UB's), physicians claims (1500's) and itemized bills as needed for both group practice and hospital requests.
Maintaining professional telephone etiquette when working with attorney offices complying with request.
Setting reminders in the Hospital and Group billing systems for the auto/liability department when an attorney letter of representation has been received.
Mailing general correspondence, liens, medical records as well as all correspondence noted above.
Complying with established departmental policies, procedures, and objectives.
Organized and coded all documents related to due diligence for acquisitions.

Sr. Account Patient Representative07/2007 to 09/2011Umass Memorial Medical CenterWorcester, MA

Knowledge of regulations with multiple major third party insurance carriers.
Responsible to follow up claims for payment.
Experience in hospital accounting, account receivable, following up on past due accounts, and adjustment due to contracts with many insurance companies; such as (HMO, PPO, Neighborhood Health, Tricare, Network, but specializing in Medicaid and Blue Cross Blue Shield).
Electronic claims submission to available online payers, access allows verification of eligibility and claim status.
Comprehensive knowledge of patient accounting procedures and handling of receivables as well as dealing with denials.
Ability to organize and prioritize work to meet strict deadlines.
Organized and coded all documents related to due diligence for acquisitions.

Supervisor05/2000 to 09/2007Price ChopperWorcester, MA

Supervisor of front end, overseeing up to 35 various employees.
Duties included delegation of front end task, resolving customer complaints; performing money transfers (western union) settling lottery and cashier drawers, and cashing customer checks.
Other duties included running a cash drawer when short staffed, assist customers with questions and concerns, calculating daily sales for the store.
Led sales calls with team members to establish sales and customer retention goals.
Hired and trained all sales staff for new store location.
Determined merchandise price schedules and discount rates.
Monitored customer preferences to determine focus of sales efforts.

Business Office (marketing)01/2005 to 05/2005Anna Maria Business OfficePaxton, MA

Researched and ordered inventory (by shopping for best possible price) for office supplies.
Researched stock market and collected marketing data.
Other duties included data entry, tracking timecards and calculating payroll, expense calculations as well as other basic administrative tasks.
Defined project deliverables and monitored status of tasks.
Collaborated with cross-functional teams to draft project schedules and plans.Served as the single point of contact for project scheduling and changes.

Education

Bachelor of Science: Business AdministrationMay2005Anna Maria CollegePaxton, MA, USA

Business Administration Coursework in Accounting 1&2, Finance 1&2, Leadership, Marketing, Management, Entrepreneurship, Economics, Diversity in the Workplace and International Business.

*Member of the Anna Maria Business Club.

Certificate of Completion in Medical Terminology , Coding & BillingMay 2012Assumption CollegeWorcester, MA, USA

Medical Terminology, codding (ICD-9 ), Billing (1500 claim forms and UB-04)

Professional Affiliations

Family Heath Center (Administrative Office Work)

Languages

Albanian (fluent), Italian (intermediate), English(fluent).

Skills

Accounting, Administrative, Attorney, Billing, Contracts, Resolving Customer Complaints, Data Entry, Economics, Finance, Insurance, Internet Explorer, Inventory, Leadership, Marketing, Medical Terminology, Meditech System, Access, Excel, MS Office, PowerPoint, Word, Payroll, Coding, Supervisor.

Resume Overview

Companies Worked For:

UMASS Memorial Medical Center
Umass Memorial Medical Center
Price Chopper
Anna Maria Business Office

School Attended

Anna Maria College
Assumption College

Job Titles Held:

Sr. Legal Rep Specialist
Sr. Account Patient Representative
Supervisor
Business Office (marketing)

Degrees

Bachelor of Science : Business Administration May2005
Certificate of Completion in Medical Terminology , Coding & Billing May 2012

Sr. Legal Rep Specialist Resume Example

Resume Score: 90%

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