I am ----------- ----------- -----------, I am Hipaa certified , I can say that I am very hardworking and flexible, can work anytime even Graveyard shift. I have 6 years experrience in Medical Insurance in US base, I assist providers to verify Benefit and eligiblity of their patients, Also I am Trained Claims specialist in medical claims in which I check if its process correctly or not, where I can make adjustments or reprocess claims if necessary.
Aside for Medical Claims , benefits and Eligiblity, I have experience in working in Dental office as Insurance verification for 1 year, I called Insurances to ask if patients has active Dental coverage, If the services is covered, I also review claims and why is it deny and call Insurance if the claims was process Incorrectly.
I am skilled in using Open dental. Ncompass, Asana, Hubstaff, MS office, Google suites and I am eager to learn to use new tools that get the Job done well.
My Previous Job require me to do as follows.
Assist providers in their billing concerns
Process adjustments in claims to pay or deny
Double checking if claims are correctly denied or accurately paid
Verifying pricing of claims (Burgess_Pricing )
Checking benefits of members according to their subscription
Follow up authorization for procedures
Editing/uploading Authorizations from Carecore(EVICORE)- UM
(Utilization Management )
Sending escalation review of Benefits and claims
Sending Benefit exception for Carecore (EVICORE ) review
Call listening /Verification of Benefits
Plog analyst
Escalation specialist for Enrollment Discrepancy
