tTo obtain employment within the accounting, financing and healthcare industry that provides the highest quality service
- Job Target: sr claim representative
- Employment Status: Employed - Will Consider Right Opportunity
- Experience Level: Not Specified
- Seeking: Full-Time
- Industry: Accounting/Finance Resumes
- Salary: neg
- Degree: Not Specified
- Security Clearance: None
- Travel: None
- Relocate:: No
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Objective
Sixteen years work experience in medical area, which had given me a chance to learn multiple tasks within a company in order to enhance my skills in adjustment, repricing, data processing and auditing
Job Target
sr claim representative
Professional Experience
| 2007 – 2008 |
QUADRAMED/INOVA DATA ENTRY |
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Merge, consolidates or inactives patient or person records, demographics master files of Alexandria, Mount vernon, Fairfax, Fair-Oaks hospitals. Documents self productivity daily and administrative duties. Self- proof and edit patient account and work-flow |
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| 1990 – 2007 |
NCPPO/WELLPOINT SR CLAIMS REPRESENTATIVE |
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Senior accounts payable,Senior medical specialist claims repricing Senior Claims Representative Repricing hospital claims and Dr's claim according to provider contracts Run checks, audit the payment claims Process payment in Netpay system Prepare daily production reports that show workflow process Research claims status Maintain underpayment request Meet department requirements of my job title. Processed between 300-500 claims perday Handled priority items for management Processed electronic submitted claims for individual group insurance company Manually processed particular types of claims according to provider contracts Trained associates in all areas of the claims process Prepared work assignments for other associates to assist team leader Provided the highest quality of customer service at all times Prepared reports for management team Prioritized workflows to better serve the customer Received telephone inquires regarding claims status Made outgoing calls to check status of claims with multiple insurance carriers Organized reports to assure customers would receive all documented informantion for our system in a timely manner Currently update provider records Make necessary changes and terminations to provider records Creates monthly reports for the management team regarding new provider status Log work in and out of an excel spreadsheets on a daily basis Meet 98% accuracy levels each month for data processing Assits with internal emails regarding contracts Handle necessary projects as assigned to help update the system accordingly. |
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| 1989 – 1990 |
MClean Rental Accounting Clerk |
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Collected checks from other branch in order to assit in bookeeping duties, deposits, payment, filling, mailing |
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Education
| 2009 | Northern Virginia Community College – Associate or Vocational Degree (AA/AS/MCSE/etc.) |
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completed 59 credits in accounting major |
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Last updated on: 2009-07-22.





