Kristin Carlile is seeking a long-term job utilizing her extensive experience in healthcare settings including hospitals, doctors' offices, and insurance claims processing. She has strong skills in customer service, medical terminology, data entry, and computer programs like Excel. Her background includes processing medical claims, verifying patient information, and assisting with customer needs in various roles over the past decade.
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Jane Doe455-484-6500Plum StreeLewis ,Georgia 585412Email .docxsleeperfindley
Jane Doe
455-484-6500
Plum Stree
Lewis ,Georgia 585412
Email:
[email protected]
Over 15 years experience in the health care industry and insurance finance including insurance billing, collections, tracking research, accounts receivable and customer service. I am proficient in the use of computerized billing payment systems.
Highly dependable, supportive team player who meets challenging deadlines.
Punctual, energetic and willing to learn and accept feedback. Ability to prioritize workload to ensure efficient task completion.
• Demonstrated capability of communicating to customers in a timely, polite manner
• Track record of meeting targets for staff and unit performance
• Typing speed: 60 wpm, 10 key proficiency
• Substantial knowledge of medical terminology, CPT codes and ICD-9 codes
CORE COMPETENCIES
General Accounting
GE/IDX Billing System
Medical Law & Ethics
REALMED
Medical Coding & Terminology
All scripts Healthcare
Solution
s
Medical Transcription
MYSIS Billing System
Patient Service Technician
Medical Management Billing Software
Epic
ICD-9, ICD-10
Microsoft Word
Excel
Power Point
Medical Management
Education
Long Community College
Ruff School
General Studies/Office Automation Studies
Medical Office Administration
Lewistown, Maryland
21015
Rest, Maryland
21252
September 1994-May 1996
September 1999-January 2001
Drexel University
DrexelUniversity
Associates Degree Healthcare Management
Pursing Bachelor of Healthcare Management
4220
Square Drive #200
4220
Square Drive #200
Hopefell, MD 21238
Hopefeel, MD 21238
July 2012-December 2014
December 2014-Present
References upon Request
Professional Experience
XXXXXXXXXX
Plain , Maryland June 2010- Present
Payment Specialist /Lead Cashier
·
Payment reconciliation of receivables for all major health care payers
·
Reconcile payment discrepancies from multiple parties
·
Perform charge entry and AR/AP data entry information
·
Assist in Month End book closing
·
Support the reconciliation of the medical hospital financial initiatives
·
Update supervisor of any discrepancies in payments from payers
·
Training new hires and current employees to make sure that they are current on company policies.
·
Post manual and electronic payment for all major insurance carriers
·
Completing insurance verifications for patient coming into the office for a same day visit and future visits
·
Processed claim forms, adjudicates for provision of deductibles, co-pays, co-insurance maximums and provider settlements
·
Researches claim overpayments and requests funds
XXXXXXXXXXXX
Tiny York, Maryland July 2008 – June 2010
Reimbursement Specialist & Payment Poster
·
Post manual and electronic payment for all major insurance carriers
·
Insurance collections with all manage care organizations and commercial insurance.
·
Actively working patient billing and collections using MYSYS and Real Med.
·
Completing insurance verificat.
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. 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. 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