Coresource - Team Lead Resume Example

Michael Moore

XXXX XX XXXXXX XXXXXX, Harrisonville, MO 64701

Ph: XXXXXXXXXXXX

XXXXXXXXXXXXXXXX

Professional Summary:

Responsible Team Lead with strong organizational abilities and a successful career in insurance and medical claims. With a commitment to providing excellent communication and time management skills. Handles tasks with accuracy and efficiency.

Skills:

Active Listening
Service Orientation

Reading Comprehension
Coordination

Writing
Critical Thinking

Social Perceptiveness
Time Management

Monitoring
Complex Problem Solving

Judgment and Decision Making

Experience:

Team Lead Feb 2003 －Present CoreSource Overland Park, KS

Direct team activities, establishing task priorities, scheduling and tracking work assignments, providing guidance, and ensuring the availability of resources.
Report project plans, progress, and results.
Release claims within designated authority level; $75,000.
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Communicate with reinsurance brokers to obtain information necessary for processing claims.
Prepare reports to be submitted to company's data processing department.
Work with appeals from providers and members; making determination and providing correspondence to all parties involved.
Review medical records for decision on emergent care claims.
Work daily with CPT, HCPA, and ICD9 codes as well as Excel and PowerStepp.
I have taken Medical Terminlogy classes as well as keeping informed and updated of HIPPA regulations.

Biller Apr 2002 －Feb 2003 Headache and Pain Center Leawood, KS

Perform bookkeeping duties, such as credits or collections, preparing and sending financial statements or bills, and keeping financial records.
Complete insurance or other claim forms.
Interview patients to complete documents, case histories, or forms, such as intake or insurance forms.
Process and record new insurance policies and claims

Claims Examiner Nov 1998 －Apr 2002 FMH Benefit Services Overland Park , KS

Pay and process claims within designated authority level.
Examine claims, further investigating questionable claims to determine whether to authorize payments.
Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Report overpayments, underpayments, and other irregularities.

Administrative Assistant Harrisonville Family Medicine Harrisonville , MO

Receive and place telephone calls.
Organize and maintain medical records, and documents.
Schedule and make appointments.
Make photocopies of correspondence, documents, and other printed matter.
Operate telephone switchboard to answer, screen, or forward calls, providing information, taking messages, or scheduling appointments.
Greet persons entering establishment, determine nature and purpose of visit, and direct or escort them to specific destinations.
Schedule appointments and maintain and update appointment calendars.
File and maintain records.

Education: