Summary
Overview
Work History
Education
Skills
Interests
Timeline
Generic

Carol Mays

Columbus,OH

Summary

For the past 20 years my experience has been with OSU Student Health Services in which I have reviewed 3rd party carrier contracts and requirements; created and maintained insurance carrier database, oversaw daily claim generation and submission process, audit claims for accuracy; reviews, researches and corrected rejected claim; prepared monthly reimbursement trends and production statistical reports; post third party; dental and pharmacy payment and denials, resolved insurance claim problem; respond to inquiries from insurance companies, patient and guarantors; analyzes trends.

Experienced with insurance claims management and policy coordination, ensuring compliance and accuracy in all documentation. Utilizes strong organizational skills and attention to detail to streamline processes and improve workflow. Knowledge of customer service and problem-solving techniques to effectively address policyholder concerns.

Overview

20
20
years of professional experience

Work History

Insurance Coordinator

OSU Student Health Services
07.2003 - 01.2022
  • Reviewed 3rd party carrier contracts and requirements; created and maintained insurance carrier database, oversaw daily claim generation and submission process, audit claims for accuracy; reviews, researches and corrected rejected claim; prepared monthly reimbursement trends and production statistical reports; post third party; dental and pharmacy payment and denials, resolved insurance claim problem; respond to inquiries from insurance companies, patient and guarantors; analyzes trends.
  • Assisted in applying for NPI numbers for The Providers
  • Assisted in Credentialing Providers
  • Submit 3rd Party Medical Claims
  • Post Payments, Dental, Pharmacy, Medical
  • Patient Statements, Denied Claims, Coding Issues

Student Benefit Coordinator

10.2002 - 07.2003
  • Insurance Registration for 3rd Party
  • Registration of Dependents for Student Health Insurance
  • Generic Account Numbers
  • Special Programs
  • Customer Services Skills
  • Organizational Skills

Information Assistant

Wexner OSU Medical Center
08.2001 - 10.2002
  • Customer Service
  • Code Blues
  • Code Red
  • Answer Incoming Calls
  • Transfer Calls
  • Page Doctors
  • Set on Consultations Calls from Outside Doctors

Education

Certificate - Medical Billing and Coding (ICD-9 and CPT)

Fort Hayes Career Center
Columbus, Ohio
08.2000

Certificate - Computer Administrative Assistant

American School of Technologies
Columbus, Ohio
11.1999

Skills

  • Client support
  • Electronic billing for third-party claims
  • Debugging code errors
  • Post-payment processing for dental and pharmacy services
  • Professional written communication with insurance companies
  • Auto accident collections
  • Insurance claims processing
  • Insurance processes
  • Insurance verification
  • Customer service and assistance
  • Claims processing
  • CPT coding
  • ICD-10 coding

Interests

  • Hiking
  • Walking
  • Gardening
  • Enjoy hobbies that combine physical activity with outdoor exploration
  • Sewing
  • Jewelry making
  • Cooking
  • Baking

Timeline

Insurance Coordinator

OSU Student Health Services
07.2003 - 01.2022

Student Benefit Coordinator

10.2002 - 07.2003

Information Assistant

Wexner OSU Medical Center
08.2001 - 10.2002

Certificate - Computer Administrative Assistant

American School of Technologies

Certificate - Medical Billing and Coding (ICD-9 and CPT)

Fort Hayes Career Center
Carol Mays