Elaine Silvernail
Athens
Summary
Seeking a position in the Healthcare industry.
Overview
21
21
years of professional experience
Work History
PDM Records Specialist
ANTHEM BLUE CROSS BLUE SHIELD
Albany, NY
- Research and update provider records via Excel spreadsheets.
COB Specialist
MVP HEALTHCARE
- I handled all the Coordination of Benefits for members of MVP. This includes the updating of information regarding other insurances besides MVP. Taking phone calls, making phone calls to members and insurance companies, and sending letters to members were also part of the job duties. I also adjusted and processed claims that were paid by MVP in error when other insurance was involved.
Claims Specialist/Customer Service Representative
ANTHEM BLUE CROSS BLUE SHIELD
01.2017 - 02.2021
- The adjudication and processing of dental, medical and hospital claims to their completion. Giving support to the Customer Service department when needed.
Hedis Medical Records Specialist
ANTHEM BLUE CROSS BLUE SHIELD
Albany, NY
05.2014 - 10.2016
- Various research supports for medical records for the Hedis project. This research includes calls to providers requesting these medical records to ensure a good NCQA rating.
Medical Records Specialist
HARMONY MILLS PEDIATRICS
Cohoes, NY
08.2013 - 02.2014
- I transferred all medical documentation from the patient’s medical charts to the EMS system. Also, information such as growth data, vaccinations, prescriptions and all other medical documentation needed.
Senior Claims Examiner
MVP HEALTHCARE
Schenectady, NY
10.2001 - 01.2013
- Reviewed and adjudicated claims for self-funded groups. Handled daily reports of the claims backlog, and the work management of all team members. Do any necessary training and attend meetings when needed.
Claims Auditor
VALUE OPTIONS
Latham, NY
05.2003 - 10.2007
- Responsible for reviewing and analyzing claims and providing feedback to claims processors.
Adjustment Review Specialist
CAPITAL DISTRICT PHYS HEALTH PLAN
Albany, NY
11.1999 - 05.2003
- I was responsible for all claim adjustments for the Government Programs line of business.
Education
Medical Billing and Coding Program with Externship -
Branford Hall Career Institute
09.2013
Medical Assistant Program with Externship - undefined
Stratford School
01.1985
Associate of Applied Science - Medical Assistant
Columbia Greene Community College
Hudson, NY05-2026
Timeline
Claims Specialist/Customer Service Representative
ANTHEM BLUE CROSS BLUE SHIELD
01.2017 - 02.2021
Hedis Medical Records Specialist
ANTHEM BLUE CROSS BLUE SHIELD
05.2014 - 10.2016
Medical Records Specialist
HARMONY MILLS PEDIATRICS
08.2013 - 02.2014
Claims Auditor
VALUE OPTIONS
05.2003 - 10.2007
Senior Claims Examiner
MVP HEALTHCARE
10.2001 - 01.2013
Adjustment Review Specialist
CAPITAL DISTRICT PHYS HEALTH PLAN
11.1999 - 05.2003
PDM Records Specialist
ANTHEM BLUE CROSS BLUE SHIELD
COB Specialist
MVP HEALTHCARE
Medical Assistant Program with Externship - undefined
Stratford School
Medical Billing and Coding Program with Externship -
Branford Hall Career Institute
Associate of Applied Science - Medical Assistant
Columbia Greene Community College