Claims Processor Resume
Work Experience:
/ – / Ford Motor Company, dba, (Automotive Components Holdings), LLC, Indianapolis, IN
Assembly Specialist (automotive parts plant)
&#; Assembled steering gears for all Ford products.
&#; Operated broach machine, valve machine and rust grinder.
&#; Reassembled parts for salvage
&#; Housekeeping.
&#; Fill in floor inspector, parts packer and quality control checker.
/ – / Visteon (Ford Motor Company), Indianapolis, IN
(Laid off) Production Checker
• Assemble of steering gears, boot clamps, rings, and installation of breathing tubes.
• Final inspection of housing units before packing finished product.
/ – / Outsourced Administrative Systems, Inc., Formally Anthem/Acordia, Indianapolis, IN
Supervisor Data Entry Department
&#; Supervised Data Entry department, processed claims, adjusted medical bills, CSR and collections.
&#; Supervised and managed all needs required to effectively administer and maintain a production shop environment that produced high quality daily inventory reduction. Held weekly staff meetings and monthly class reeducation and testing on changes within our department to ensure that all staff members were working within the same parameters.
&#; Evaluated and interviewed potential new hires.
&#; Provided training for all new hires in data entry.
&#; Oversaw the implementation of new account specifications.
&#; Challenged with the task of maximizing claim processing on the first pass, I led my team to achieve this goal by increasing the auto adjudication rate from % to % by means of quality data entry.
&#; Educated staff personnel on various system interfaces.
&#; Responsible for conducting testing and training for department upgrades on best practices for projects related to data entry advancement.
&#; Demonstrated our advanced technology application MACESS and health care imaging system for the Board President and Director of Sales, as well as potential new clients and guest.
&#; Educated providers through standard correspondence and courtesy phone calls about improper billing errors which result in claim processing delays.
&#; Frequently requested by senior management to oversee and execute inventory reduction plans in other areas of our company.
/ – / Anthem, Indianapolis, IN
Claims Processor/Customer Service
Re-pricing of claims, adjustments, enrollments and auditing of accounts.
/ – / Methodist Hospital, Indianapolis, IN
Claims Temporary Support Services
Account-Analyst and medical biller for aged and third party accounts and collections.
/ – / Sweet Water Coffee Company, Fishers, IN
Administrator of Operations
Managed day-to-day operations. Maintained records of purchases, bank deposits and personnel records, coordinated with owner updates of information for implementation.
/ – / Apria Healthcare Group, Indianapolis, IN
Account Specialist
Knowledge of Indiana Aims System, electronic billing, aged accounts, durable medical equipment and supplies, PA authorizations and modifications, third party inquiries and adjustment forms, PCCM program and RBMC.
/ – / Methodist Hospital, Indianapolis, IN
Claims Temporary Support Services
Account Specialist, placed at Methodist Hospital, clarified and resolved aged accounts, customer service.
/ – / Medical Accounts Group/All Med, Indianapolis, IN
Account Specialist
Clarified and resolved aged accounts, customer service.
/ – / Alpha Health Pavilion-OB/GYN, Jackson, NC
Office Manager
Supervision of eleven () office personnel, including nurses, insurance clerks and receptionist. Medical insurance billing, AP/AR, hiring, training and troubleshooting.
Software Novell and Windows NT network operating systems. Microsoft Word and Excel. The MACESS imaging and workflow system. Health Care Procedure Coding System (HCPS), MIMS and Automatic Transaction Processing (ATP).
Education Broad Ripple High School, Indianapolis IN
Graduate
