Resume CA 2
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Kristin K. Glassee has over 15 years of experience in healthcare claims processing, customer service, and case management. She has held roles as a claims analyst, career advisor, premium auditor, and customer service representative. Her responsibilities have included processing and adjusting medical claims, managing client caseloads, conducting audits, and providing support to members, providers, and other customers. She has strong computer skills and experience with common software programs and healthcare databases.
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RESUME JAN 2016MAURISA GOLDBERG
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Maurisa Goldberg has over 20 years of experience in customer service roles within the healthcare industry. She has extensive skills in medical billing, claims resolution, and client engagement. Additionally, Ms. Goldberg has a proven track record of providing excellent customer service and forming positive relationships with patients, medical staff, and insurance representatives.Resume CA 2
- 1. KRISTIN K. GLASSEE 19018 Parthenia Street #12 Northridge, CA 91324 203-317-1922 glbrk77@gmail.com EMPLOYMENT April 2012-August 2015 Affinity HealthPlan, Bronx, NY Claims Analyst/Department Compliance Coordinator Adjustments of professional medical and outpatient/inpatient hospital claims Review, Examine and Process professional medical/ outpatient/inpatient hospital claims Provide customer service to members and providers Resolve/troubleshoot claims issues, billing and provider issues/Review and resolve all 24 Hour Complaints Process correspondence and appeals from providers/members November 2009-March 2012 Rescare/Arbor Education and Training, Brooklyn, NY Career Advisor/Case Manager Managed a case load of 100 or more clients Intakes Client assessments/Recruitment Referrals to other outreach programs Case Review/Case Notes Outreach calls/Reception June 2009-November 2009 Performance Tracking Specialist190 Analyzed and Reviewed Data Created Spreadsheets Provided results for various departments and site managers Outreach phone calls to specific clients Interviewed clients Setup meetings with site managers, project directors, and supervisors Special projects as assigned November 2008-February 2009 Insurance Overload Staffing (Temp Agency), Wallingford, CT Community Health Network Claims Examiner Process Medicaid hospital/medical claims Process medical notes/inquiries Handled provider inquiries Handled member inquiries Adjustments Special projects as assigned November 2007-May 2008 Overland Solutions, Overland Park, KS (Corporate Office) Premium Auditor/Field Representative Audit worker’s compensation/general liability policies Call/negotiate day and timeframe of appointment for audit Answer incoming calls from insured or agent Discuss results of audit with insured or agent Maintain daily progress log May 2007-Oct 2007 Advanced Behavioral Health, Middletown, CT
- 2. Credentialing Specialist Process incoming provider applications Answer incoming calls from providers Update provider files Maintain provider database Attend committee approval meetings Special projects as assigned May 2006-May 2007 Customer Service Representative Answer incoming calls from providers Clarify authorizations Other general questions, i.e. eligibility, provider contract information Other clerical duties, i.e. denial reports October 2001-March 2005 Cigna Healthcare, Bristol, CT Senior Claims Associate Process correspondence mail, including but not limited to hospital and medical claims Handled intermediate to complex claims issues Troubleshoot claims issues/provider issues Adjustments Refunds Stop Payments/Reissues Overpayments/Underpayments Customer Service EDUCATION Sept 2001-Dec 2006 Post University B.S., Bachelor of Science Legal Studies Paralegal Certificate Minor: Marketing Aug 1988-Sept1995 B.A., Bachelor of Business Administration Marketing Degree Pending SKILLS: MS Outlook MS Word MS Excel MS Access MS PowerPoint Internet Oracle IDX Typing Skills (60-65 WPM) Notary Public (commissioned 2012)