Experience

• 

  PRO MED Services Group

  • Maitland, FL

  • Medical Bill Analyst

    • Jan 2003 - Present
    • Maitland, FL

    Evaluate medical bills/statements for accuracy in coding/billing practices (Physician, Hospital, ASC, Surgical); Review/Interpret Medical Documentation; Research/Apply nationally recognized coding/reimbursement guidelines; Understanding of Insurance (Third Party Injury, General Liability, Auto, Medicare, WC, Dental); Understanding of Usual & Customary methodologies for charges/reimbursement; Understanding of specific state/Federal Fee schedules/guidelines/Statutes; Preparation of Statistical reports

• 

  CNA Insurance

  • Maitlandd, FL

  • Billing Specialist

    • Jan 2000 - Feb 2001
    • Maitlandd, FL

    Manage accounts in the coordination of all activities of billing, collection and accounting in specialty area for assigned accounts; Perform funding program analysis and reviews to comply with established procedures and policies; Complete reconciliation of financial data in support of billing and collection activities; Determine and initiate corrective actions to resolve billing and collection issues/disputes; Provide advice on billing and collection matters to customers and consults with field underwriting offices in the selection and utilization of billing plans and methods; Work with customers, brokers and agents in the pursuit and resolution of collection matters including legal collections; Perform complex reconciliation, collateral projections and or investigation/resolution of processing problems and reconciling items.

• 

  Travelers

  • Miatland, FL

  • Claims Intake Specialist

    • Aug 1998 - Dec 1999
    • Miatland, FL

    Manage/process all requests via phone/email; coordinate with staff to ensure accuracy and provide support; Enters loss information into appropriate claims application; Review/evaluate incoming loss documents for complete and accurate information; Receive first notice of loss, reviews and/or locates policies, validates coverage applied to claim to determine appropriate line of business and loss type; Receive claim reports and information inquiries from internal/external (insured, broker, vendor) business partners and researches, then provides response; Review applicable systems to determine presence of duplicate claims; Validate and locates missing policy information prior to entering default information; Adhere to all special handling instructions for claims routing.