Summary
Overview
Work History
Education
Skills
Timeline
Generic

Catina Curtis

Raleigh,NC

Summary

I would like to obtain a challenging career in a company where I can utilize my Medical billing and coding processes. I also am knowledgeable in benefits and insurance Health claim processes. I have Claims Processing experience Prior experience with BCBSNC policies, claims, and membership procedures and Front end processing. Prior experience in claims, customer service, and Claims Adjustments Broad-based knowledge of claims coding and processing Knowledge of BCBS customer service protocols, policies, and procedures Knowledge of BCBSNC certificates and the ability to interpret benefit information for special provisions Commitment to high quality customer service Able to pay A edition to detail and excellent organizational skills Effective verbal and written en communication skills work independently, exercise good judgment, and make fact-based decisions work in a high- pressure environment and deal effectively with customers. Dynamic insurance professional bringing 15 years in the field of insurance with emphasis on Health and Mental Health claims.

Overview

34
34
years of professional experience

Work History

Claims Examiner

Mental Health
Durham, NC
02.2005 - Current
  • Investigated questionable claims to determine payment authorization.

Double
02.2005 - Current
  • Checked and reviewed documentation for denied and accepted insurance claims
  • Paid and processed claims within designated authority level
  • Handled and processed variety of claims, including Mental Health Claims and Autism Claims
  • Reviewed claims to ensure accuracy, resulting in multiple claim reductions.

Tester

COVID, Labcorp Of America Covid Processing and Labcorp
Research Triangle Park, NC
04.2020 - 05.2020
  • Processed and tested Coved Samples for
  • Reeving positive or Negative Samples
  • Batched and uploaded positive samples into, Data Base to be processed for contract tracing.

Medical Claims Processor

Claims Professional Beacon Health
Morrisville, NC
10.2017 - 05.2020
  • Processed Mental Health Claims for BlueCross and BlueShield of New Jersey
  • Options Worked edits to get claims paid or denied for processing
  • Processed Opioid

Claims

Farmers Bank
10.2017 - 05.2020
  • Suicide Claims and Autism Claims
  • Experience in working High
  • Dollars claims for Bluecross providers
  • Data Entry and Balancing Reconciliation
  • Mechanics and

01.1996 - 03.2007
  • Durham, Designed, managed and verified accuracy of financial statements
  • NC Reviewed financial statements and files to identify opportunities to, improve processes and increase efficiency
  • Data Entry and Balancing Reconciliation from different banks branches.

Claims Processor

Kelly Services
Durham, NC
02.2005 - 02.2006
  • Input ed data into the system, maintaining accuracy of provider coding
  • Claims Process Front End BlueCross information and reported services
  • BlueShield of NC Based payment or denials of medical claims upon well-established criteria, for claims processing
  • Administered standard contract benefits to process pending claims for dental benefits
  • Sent clinical request and missing information le ers to obtain incomplete information
  • Reviewed claims for accuracy before submi ing for billing.

Data Entry Operator

North Carolina Central University
Durham, NC
09.1990 - 10.1992
  • Completed accurate and efficient data entry and database updates to Durham, NC support business operations., Identified, corrected and reported data entry errors
  • Reviewed and updated account information in company computer system
  • Executed data verification to ensure expedient error detection
  • Input client information into spreadsheets and company database to provide leaders with quick access to essential client data
  • Documented data entry completions in corresponding logbooks
  • Identified and corrected data entry errors to prevent duplication across systems.

Education

Associate's degree - Physiology

North Carolina Central University
10.1996

Kaplan University

Skills

  • ICD 10-CM/PCS, CPT& HCPCSanalyzing improvements
  • Policies
  • BCBSNCEOB, CMS-1500Able to Coordinate Medicare
  • Processes
  • BCBSNCUB-04 and Patient Encounter Forms payment (10 years)
  • Coding I
  • Liability Medical Records Management Review of Claims (10 years)
  • Coding
  • Possible Fraud ClaimsHIPPA Compliance3M Encoder
  • Quality
  • HER Desktop
  • Reconciling
  • CMS ReimbursementClaims AdjudicationClaims
  • ProcessingAdjustmentsBenefits EligibilityBCBSNC
  • Claims and Membership processing Microsoft (10 years)
  • Multitasking office Excel Authorization and provider verification (10 years)
  • MS Office
  • Autism Experience
  • EMR Systems
  • Medical Coding
  • Documentation Review
  • Microsoft Word
  • Excel
  • 10 Key Calculator
  • Medical Billing
  • ICD-9
  • Anatomy Knowledge
  • Insurance Verification
  • Medical terminology
  • Hospital experience
  • Data entry
  • Medical office experience
  • Sales

Timeline

Tester

COVID, Labcorp Of America Covid Processing and Labcorp
04.2020 - 05.2020

Medical Claims Processor

Claims Professional Beacon Health
10.2017 - 05.2020

Claims

Farmers Bank
10.2017 - 05.2020

Claims Examiner

Mental Health
02.2005 - Current

Double
02.2005 - Current

Claims Processor

Kelly Services
02.2005 - 02.2006

01.1996 - 03.2007

Data Entry Operator

North Carolina Central University
09.1990 - 10.1992

Associate's degree - Physiology

North Carolina Central University

Kaplan University
Catina Curtis