Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Erica Weimer

Mckeesport,Pennsylvania

Summary

Ambitious, career-focused job seeker, anxious to obtain an entry-level medical coding position to help launch career while achieving company goals. Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Hardworking employee with customer service, multitasking, and time management abilities.

Overview

6
6
years of professional experience

Work History

Claims Processor 3

Highmark Blue Cross Blue Shield
Pittsburgh, PA
05.2022 - 07.2023
  • Researched discrepancies between submitted documentation and actual records to identify errors or omissions.
  • Performed additional duties as requested by management team.
  • Reviewed history records to determine benefit eligibility for services.
  • Maintained accurate records of all processed claims in accordance with departmental requirements.
  • Reviewed and verified insurance policy information to assess coverage and determine appropriate claims processing procedures.
  • Used insurance rate standards to calculate premiums, refunds, commissions and adjustments.
  • Processed claims for payment or forwarded to appropriate personnel for further investigation
  • Adhered to all applicable laws, regulations, and company standards while processing claims.
  • Collaborated with fellow team members to manage large volume of claims.
  • Retained strong medical terminology understanding in effort to better comprehend procedures.
  • Coordinated benefits with medical insurance plans and Medicare providers.
  • Processed a high volume of incoming claims in accordance with established policies and procedures.
  • Analyzed and evaluated claim forms, medical reports, bills, and other documents to ensure accuracy of data.
  • Applied knowledge of coding systems such as CPT-4 and HCPCS codes for proper reimbursement.
  • Organized information by using spreadsheets, databases or word processing applications.
  • Verified claim data correctness in preparation for processing.
  • Processed claims according to established quality and production standards and made corrections and adjustments to solve problems.
  • Checked documentation for appropriate coding, catching errors and making revisions.
  • Exceeded customer satisfaction by finding creative solutions to problems.
  • Understood and followed oral and written directions.
  • Completed day-to-day duties accurately and efficiently.

Elite Team Care Connect

Allegheny Health Network
Pittsburgh, PA
01.2021 - 05.2022
  • Adjusted schedules as needed due to cancellations or delays.
  • Communicated schedule changes to appropriate department personnel and other ancillary areas.
  • Maintained updated records of all scheduled appointments.
  • Set and confirmed all levels of customer appointments.
  • Utilized computer applications to manage daily tasks efficiently.
  • Answered customer questions and scheduled appointments.
  • Followed up with patients regarding upcoming appointments.
  • Handled incoming calls and directed callers to appropriate department or employee.
  • Collaborated with other departments to coordinate care plans and schedules.
  • Managed incoming calls to schedule appointments and answer questions.
  • Coordinated with physicians' offices regarding referral requests.
  • Advised patients on the best options for their particular situation.
  • Communicated with clients and caregivers to inform of schedule changes, cancellations or additions.
  • Answered phones and routed voicemails to respective employees.
  • Offered reception coverage to relieve staff during absences or breaks.
  • Completed timely changes and updates to schedules in central scheduling system.
  • Maintained positive working relationship with fellow staff and management.
  • Provided information regarding medical services, fees, and payment options.
  • Processed patient referrals and insurance verifications.
  • Resolved customer inquiries in a timely manner.
  • Provided reminder calls to clients prior to scheduled visits.
  • Provided excellent service and attention to customers when face-to-face or through phone conversations.
  • Assisted with customer requests and answered questions to improve satisfaction.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Understood and followed oral and written directions.
  • Displayed strong telephone etiquette, effectively handling difficult calls.
  • Exceeded customer satisfaction by finding creative solutions to problems.

Customer Care Representative

UPMC
Monroeville, PA
10.2017 - 04.2021
  • Applied knowledge of medical terminology and insurance processes to support office administration productivity.
  • Processed payments, reconciled accounts receivable reports and generated invoices for services rendered.
  • Managed front office customer service, appointment management, billing and administration tasks to streamline workflow.
  • Trained new staff on office procedures, insurance processes and medical terminology.
  • Ensured compliance with HIPAA regulations by maintaining confidentiality of all patient information.
  • Checked patients in and out for appointments and collected co-payments.
  • Routed laboratory or diagnostic results to appropriate staff.
  • Took messages from patients and promptly relayed to appropriate staff.
  • Entered insurance, demographics and health history into patient database.
  • Informed patients of financial responsibilities prior to rendering services.
  • Answered multi-line phone system and directed callers to requested personnel and departments.
  • Checked-in patients when they arrived at the front desk; obtained necessary paperwork from them prior to check-in process.
  • Straightened up waiting room to maintain neat and organized space.
  • Assisted physicians with finalizing reports, speeches or presentations.
  • Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
  • Managed multiple tasks simultaneously while providing excellent customer service in a busy office environment.
  • Maintained a clean reception area by restocking supplies, cleaning furniture surfaces and vacuuming carpets.
  • Adhered to HIPAA requirements to safeguard patient confidentiality.
  • Greeted patients and visitors to answer questions or refer inquiries to appropriate personnel.
  • Scheduled appointments, optimizing patient satisfaction, provider time and treatment room utilization.
  • Verified patient demographics, entered data into electronic health record system and provided support to physicians.
  • Photocopied insurance cards, documented details and verified patient coverage for upcoming procedures or appointments.
  • Assisted in preparing treatment rooms for patient examinations by stocking supplies and ensuring proper sanitation standards were met.
  • Provided customer service to patients including answering questions about treatments or services offered by the practice.
  • Maintained patient accounts by obtaining, recording and updating personal and financial information.
  • Created new patient files upon request while adhering to organizational policies regarding file maintenance.
  • Provided administrative support such as filing documents, photocopying materials and organizing office supplies.
  • Greeted patients, verified insurance information and collected copays.
  • Prepared reports, invoices, letters, or medical records using word processing, spreadsheet, or other software applications.
  • Conducted patient intake interviews to collect medical information and insurance details.
  • Transmitted medical records and other correspondence by mail, e-mail, or fax.
  • Delivered high-quality administrative and customer service to sustain patient and work flows.
  • Monitored appointment schedules to ensure timely arrival of patients for their scheduled visits.
  • Managed office phone lines by checking voicemail, returning calls and directing messages to team members.
  • Answered telephones and directed calls to appropriate medical or adminstrative staff.
  • Called patients to confirm scheduled appointments and obtain additional details.
  • Handled incoming mail including sorting letters according to departmental guidelines.
  • Greeted patients, determined purpose of visit and directed to appropriate staff.
  • Interviewed patients to complete case histories and intake forms.
  • Carried out daily tasks by professionally communicating with physicians, nursing staff, technicians and medical assistants.
  • Greeted each patient pleasantly and offered desk sheet for easy sign-in.
  • Processed patient payments and scanned identification and insurance cards.
  • Answered incoming calls, addressed inquiries and routed messages to appropriate personnel.
  • Retrieved faxes and uploaded documents to patient charts to assist clinical staff.
  • Coordinated with insurance companies regarding payment verification processes prior to delivering treatment plans.
  • Communicated with patients with compassion while keeping medical information private.
  • Ordered and maintained supply inventory for medical office.
  • Provided excellent service and attention to customers when face-to-face or through phone conversations.
  • Maintained updated knowledge through continuing education and advanced training.
  • Completed day-to-day duties accurately and efficiently.
  • Displayed strong telephone etiquette, effectively handling difficult calls.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.

Education

High School Diploma -

Mckeesport Area Senior High School
Mckeesport, PA
06-2000

Accociates - Medical Coding/Terminology

CPC AAPC
AAPC

Skills

  • Payments Posting
  • Transactions Reconciliation
  • Claims Review
  • Allocating Claims
  • Medical Terminology Knowledge
  • Accuracy and Precision
  • Regulatory Compliance
  • Policy Interpretation
  • Data Entry
  • Eligibility Determination
  • Teamwork and Collaboration
  • New Policies Processing
  • Insurance Claim Forms Review
  • Claim Amount Calculations
  • Customer Service
  • Outstanding Clerical Abilities
  • Claims Processing
  • Appointment Scheduling
  • Payment and Investigation Escalations
  • Insurance Coverage Verification
  • Insurance Plan Verification
  • Exceptional Recordkeeping Abilities
  • Electronic Authorization Processing
  • Background in Insurance
  • Medical Terminology
  • Information Verification
  • Insurance Terminology
  • Documentation Abilities
  • Recordkeeping Organization
  • Attention to Detail
  • Microsoft Office
  • Understanding of Medical Terms
  • Organizing and Prioritizing Work
  • Decision-Making
  • Paperwork Processing

References

References available upon request.

Timeline

Claims Processor 3

Highmark Blue Cross Blue Shield
05.2022 - 07.2023

Elite Team Care Connect

Allegheny Health Network
01.2021 - 05.2022

Customer Care Representative

UPMC
10.2017 - 04.2021

High School Diploma -

Mckeesport Area Senior High School

Accociates - Medical Coding/Terminology

CPC AAPC

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Erica Weimer