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Kristin Lear Resume

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Kristin Lear Resume

  1. 1. Kristin Carlile 3721 Bardstown Road #402 Louisville, KY 40218 Kristin.lear@yahoo.com Objective With my vast knowledge of the healthcare industry, both in a hospital and office setting as well as dealing with medical and third party claims I believe I am dually qualified for a multitude of positions. This knowledge provides me with the confidence to perform my duties effectively and efficiently. I am looking to find a long term job where I feel my presence can do the most good. Summary of Qualifications • Extensive customer service experience • Front desk / receptionist expertise • Knowledge of medical and insurance terminology • Excellent written and verbal communication skills • Goal oriented • Familiarity with medical terminology and coding • Ability to manipulate and update spreadsheets using Microsoft Excel Work Experience Copay Recovery Unit | Pharmerica 11/15-present Responsibilities include verifying the low income subsidy level of residents who reside in long term care facilities, call insurance companies to obtain copay reimbursement and excluded medication information as well as contacting long term care facilities to collect evidence following CMS guidlines to update our residents to a low income subsidy level 3. Claims Processor | Firstsource 09/14-10/15 Responsibilities include determining whether or not incoming medical claims should be paid or denied. Patient and treatment information must be verified. By following state guidelines regarding treatment I am able to determine whether or not the claim can be paid or must be sent
  2. 2. back to the provider for resubmission. If I am unable to make a determination based on the information provided I am required to send that claim to appropriate department for clarification or updates. Client Account Specialist | RxCrossroads 05/14-09/14 Responsibilities include processing incoming orders, faxed, e-mailed and phone; entering the order , verifying physicians’ license information, checking for duplicate orders, insuring the order is shipped in a timely fashions, managing my own account; communicating with customers/clients, e-mailing/faxing order and account set up forms, running the acknowledgement of receipt report, and verifying the accuracy of co-worker’s orders. Receptionist | Dr. Norman Radtke 11/13-01/14 Responsibilities include scheduling appointments and checking in patients upon their arrival, collecting co-pays, entering insurance information into MDOffice, filing and preparing patients’ charts, scanning appropriate medical documents into EMR, and transferring medical records to referring doctors. Claims Processor | Trover Solutions 01/11-05/13 Responsibilities include investigating events, accurately verifying accident details, and documenting incoming mail. Handling calls from clients, members, insurance companies and attorneys. Customer Service Representative | Trover Solutions Responsibilities included handling calls for a variety of health insurance clients, documenting correct claim and treatment information into files. Unit Secretary/Monitor Technician| Kosair Children’s Hospital 03/09-01/11
  3. 3. Responsibilities included clerical reception, admission, communication, accurately transferring doctor’s orders into the computer system, delivering medication, and assuring each employee had the appropriate equipment. Monitor Technician responsibilities included monitoring the heart rhythms of patients, notifying nurses of rhythm changes, tracking patient admission and discharge, and preparing a summary of the shift’s activities. Education University of Louisville December 2007 Bachelors in Arts and Sciences - English Major Louisville Male High School August 2003 Diploma- with a concentration in pyschology References Brad Wiseman- Trover Solutions- Customer Service Supervisor 502-214-5197 Sharon Fox- Trover Solutions- Claims Processor Supervisor 502-214-5183 Linda Clem- Firstsource- Quality Analyst 502-964-3497

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