I was a Claims Assistant and opened new insurance claim files. I assigned new claims to corresponding adjusters. I confirmed medical appointments and verified insurances/ policies. I was in charge of claims log update and maintenance on Excel. I submitted invoices. Translated from English to Spanish when needed. I typed medical spreadsheets on Excel. I prepared Releases and Closing Reports. I requested police accident reports. I filed claims on VCA systems. I extended car rentals to our claimants through our ARMS systems. I answered a multi-line phone system. I opened the office in the mornings. I filed, faxed and performed other office duties as needed.
- Claims Assistant at MG Bush Safety & Claims
- Legal Assistant at Della Mura & Ciacci, LLP
- Sales Associate/Customer Service at Macy's
- Office Receptionist at Bronx Community College
5 months at this Job
I’ve been with Keenan & Associates for seven years. I started off as a file clerk and worked my way up to a claims assistant.
- Claims Assistant at Keenan & Associates
at this Job
Claims assistant responsible for est. Comp and pension claims, associating evidence and preparing for decision. Retired July 2018.
- Claims Assistant at Department of Veterans Affairs
- Waiter and Bartender, maitre d at Marina Jacks
19 years, 7 months at this Job
- Some college
Assist Adjusters in handling Workers Compensation claim files, including issue payments, requesting medical documentation to support injuries, scheduling appointments. In addition tofiling Workers Compensation state forms with several states, including Georgia, Virginia, West Virginia, Alabama, Arkansas and Mississippi. Brief experience in filing state forms with Noth Carolina and South Carolina. Promoted to a claims Assistant from First reports Clerk in 2016.
- Claims Assistant at AmTrust North America
- Clerk at SERTEC CORPORATION
- Claims Assistant at
5 years, 1 month at this Job
- Some college
• Claims assistant to the Director of Compliance
• Prioritize day to day task based on emails received and special projects given.
• Review reports received from the stop loss carrier (check for any discrepancies that may occur)
• Create a standard schedule to track all groups/clients report and claimant information
• Following HIPAA guidelines and staying up to date on all current training
• Created a procedures manual for training and development (Claims and Reporting Department)
• Following up with TPA’s and Claims Adminstrators regarding reports or information not received on the group/client
• Track High Cost Claimants to reimburse the client on all catastrophic claims that go over the specific deductible threshold
• Receive and review checks and or EOR’s sent from the carrier (for any denied charges or pended charges)
• Working with multiple claims administrators on reports and group/client set-up
• Understanding Specific Deductuble and Aggregate stop loss
• Weekly meetings to go over all prospect groups/clients (ASO, Fully Insured, and Self Funded)
- Claims Assistant at Stop Loss Insurance Services Amwins Group
- Behavioral Health Intake at UnitedHealth Group
- Call center manager at 4M Pharmaceuticals
- Teller-Temporary at Green Bank
1 year, 2 months at this Job
- High school or equivalent - Business Management
1201 Broad Rock Blvd Fiscal Service, Department of Revenue Richmond, VA 23249 United States 3/5/2018 - Present Salary: $45,430 GS-7 Step 3 Hours per week: 40 Claims Assistant Supervisor: Laquita Bruce (804)675-5000 ext. 3352 Okay to contact this Supervisor: Yes I am active member of the Medical Care Collections Program (MCCF) and Non-Medical Care Collections Fund (Non-MCCF) revenue cycle program, and functions within the scope of the Richmond VA Medical Center for revenue reimbursement. My primary functions include developing comprehensive internal standard operating procedures, and detailed tracking systems, building a foundation and objectives for the long-range achievement and organization of the TRICARE, DoD and Champ VA Non-MCCF programs and agreements. The work involves gathering information, identifying and analyzing issues relating to patient accounts and developing recommendations to resolve substantive problems. Integrates organizational efforts and communications about these programs in conjunction with VAMC Richmond, the Consolidated Patient Account Center/Mid-Atlantic (CPAC/MACPAC), Utilization Review Nurses, the TRICARE Regional Office, DOD Military Medical Support Office (MMSO) and VA's Health Administration Center (HEC) to ensure detailed tracking and optimal generation and receipt of DoD, TRICARE, and Champ VA insurance claim reimbursements. Serve as one of the facility's first and third-party service representative for Non-MCCF programs. Working as liaison between Veterans and Non-MCCF payers, the primary functions include assisting Veterans and VAMC Richmond staff with verifying and explaining eligibility, benefits, billing issues, pre-authorizations, co-payments, and denials. I perform a variety of clerical, administrative and technical duties/responsibilities in support of management with the intent of accomplishing the administrative requirements of the organization to which assigned; therefore, contributing to the efficient and effective accomplishment of the overall revenue Program. Using VISTA and other revenue and insurance related data-basis, the incumbent will counsel, monitor and validate all Non-MCCF patient authorizations, claims, referrals and pre- and post-billing transactions associated with Active Duty (AD), Veteran and Dependent treatment and care using Military Medical Support Office (MMSO), Defense Enrollment Eligibility Reporting System (DEERS), TRICARE Regional Offices, Health Administration Center (HEC) and the Veterans Affairs Regional Office (VRO) offices, contacts, websites, policies and handbooks. Responsible for the coordination and development of all specialty claims for the TRICARE, DOD, and Champ VA Non-MCCF programs, ensuring accurate claims are created and resolved in compliance with current policies, procedures and regulatory laws. Analyze accounts receivable for assigned claims in a timely manner to determine status of claim errors, obstacles or reasons not billable (RNB) that could delay/prevent payment. Assists in identifying billable Non-MCCF encounters and correctly track any non-billable encounters/claims in Vista. Also assists insurance verification process through Insurance Buffer Capture (ICB) by ensuring all TRICARE, DOD policy information is up to date and accurate in accordance with DEERS. Contact Patients who have dual Veteran/TRICARE status to verify which status they will be using for each episode of care. Review payments and Explanation of Benefits (EOB) received from the insurance companies. Researches and follows up with unsatisfactory third-party response (i.e., claim denials, inadequate payment, and non-response to claim submission to ensure maximum patient account reimbursement to the facility. Runs weekly Billing Reports required to audit all AD (Active Duty), TRICARE and Champ VA claims to ensure correct revenue Source Codes are identified and that the correct Billing Rate Types are selected. Initiates correspondence and phone communication to insurance companies and patients as needed, to provide and collect information necessary to process insurance claims. Accepts and processes all Release of Information (ROI) and Freedom of Information Act (FOIA) requests for AD, TRICARE, and Champ VA Non-MCCF encounters and processes them within the designated database. Assist as a point of contact and subject expert with regards to the Non-MCCF program and support the Hunter Holmes McGuire Veterans Medical Center and all the community based outpatient clinics (CBOC's) assigned, on potential reimbursable outpatient cases. Works with current staff as needed on the procedures of billing and auditing and keep the unit compliant in all Directives, Policies and Procedures or Challenges that may arise. Assists staff members with maintaining Share Drive Documents with the most up to date information with regards to the Non-MCCF program. Completes TRICARE/Champ VA, training seminars and Monthly and/or bi-weekly Conference calls, or completes on-line training as assigned, to increase program knowledge base and stay within policy and procedures.
- Claims Assistant at Department of Veterans Affairs Medical Center
- Health Benefits Advisor at Department of Veterans Affairs Medical Center
- Administrative Assistant (HBA) at Department of Veterans Affairs Medical Center
- Medical Support Assistant at Department of Veterans Affairs Medical Center
1 year at this Job
I have many responsibilities. I enter and print checks for the property/auto adjusters on a daily basis. I enter any information needed on the as as needed for the adjusters. For example, I may have to make a reserve change so that the amount available is enough for a subrogation or salvage check to go through. I answer the phones, take care of the mail, send faxes, use copier and scanner, and complete UPS orders on a daily basis for our company as needed. I help the adjusters with their claims as needed and pull their files for the following week that they need to look at. On a weekly basis I have prep work from where the adjusters have closed a file. I have to make sure the file is closed and then prep (separate the files) and send them to our Home Office to be imaged. I also type letters for the adjuster sthat are sent to attorneys, insureds, or claimants.
- Claims Assistant at Farm Bureau Regional Claims Office
- Facilitator at Sr High School
- First Grade Teacher at Martin Primary School
- Bradford Jr at Sr High School
4 years, 5 months at this Job
- Master of Science - Criminal Justice
- Master of Arts - Education
- Bachelor of Science - Elementary Education
Claims Assistant to Claims Manager
● Survey Manager
● Additional Office Duties
- Claims Assistant and Survey Manager at G&M Marine
- Paralegal at Scott, Vicknair, Hair & Checki at Civil and Property Casualty Law
- Legal Assistant to Erin Parkinson, Jose Barro at Civil and Property Casualty Law
- Legal Assistant/Paralegal at W. Glenn Burns of The Willis Law Group, PLLC
1 year, 9 months at this Job
- - Theater/Criminal Justice
• Filed hazard insurance claims on behalf of mortgage companies and tracked the progress of all outstanding insurance claims from start to finish.
• Prioritized daily workload by monitoring unit's review group, need from lists, police/fire report lists, e-mails, mailbox, notice of claim letters, and proofs of loss.
• Updated client platforms and systems as authorized by the client and provided additional administrative support to units when needed.
- Claims Assistant at Rutledge Claims Management, Inc
- Barista at Starbucks, Inc
- Marketing Assistant at Starbucks, Inc
- Associate Market Research Analyst at Starbucks, Inc
3 years, 6 months at this Job
- Bachelor of Arts - International Business
As a claims assistant I contacted employers and doctors offices to verify the claimants work status, prepared/mailed letters to claimants regarding claim changes and payment information as well as calculated and issued benefit payments to the claimant.
- Workers' Compensation Claims Assistant at York Risk Services Group
8 years, 10 months at this Job
- High School Diploma