Mary Gascoigne
Marion,SD
Summary
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.
I have over 39 years experience examining and processing health insurance claims.
I am knowledgable in CPT codes, Revenue codes for the UB forms and ICD 10 codes, HCPC codes and the NDC codes for prescriptions.
Overview
39
39
years of professional experience
Work History
Claims Examiner
Avera Health Plans
Sioux Falls, SD
09.2014 - 01.2024
- Handled and processed variety of claims, including Medicare suppliment plans and helped out on the regular business lines of work also.
- I worked on special projects that my supervisor would ask me to do.
- I would help out other departments when they needed it.
- I am very eager to learn new things and do the best job i can!
Accounts Payable Clerk
Sanford PFS
Sioux Falls, SD
04.2003 - 12.2013
- Reviewed claims that were denied and worked to get them paid by the insurence companies.
- I worked on the appeals of the denied claims.
- I volunteered to do some training of my fellow employees when we got a new system.
Bluecard Patient Representative Associate
Wellmark Blue Cross Blue Shield
Sioux Falls, SD
07.1996 - 07.2003
- I took phone calls from providers that had questions on denied claims.
- I worked all the appeals for the claims that were sent in for review or for reconsideration.
- Demonstrated exceptional service skills by going above and beyond to satisfy customers on phone and in person.
- Consistently met daily performance goals set by management team members.
Claims Processor
Wellmark Blue Cross Blue Shield
Sioux Falls, SD
01.1993 - 07.1996
- Entered the claim information into the system for processing of the claims.
- Mainly data entry of all claim forms Including HCFA and the UB92's
Watts
Wellmark Blue Cross Blue Shield
Sioux Falls, SD
11.1987 - 09.1993
- I made phone calls to the providers for invalid or missing information on the claim forms that were submitted.
- I would get these questions from the claims examiners.
- I built great relationships with multiple providers across the state.
File Room Clerk
South Dakota Blue Shield
Sioux Falls, SD
08.1984 - 11.1987
- Filed the paper claims into folders once the claim had already been processed by the examiner.
- Operated the Microfishe machine.Which involved feeding the paper claim forms into the machine to put them on film for easier retrival.
- I also did some of the mail room duties when they needed help
Education
Executive Secretary Program
Nettelton Business College
Sioux Falls, SD08-1983
High School Diploma -
Marion High School
Marion, SD05-1983
Skills
- Data Verification
- Insurance Knowledge
- Policy Interpretation
- Claims Processing
- Investigative Skills
- Microsoft Office Suite
- Team Collaboration
- Critical Thinking
- Claim Form Analysis
- Decision-Making
- Claims Evaluation
- Active Listening
- Claims File Management Processes
- Payment Processing
- Computer Skills
- Fraud Identification
References
References available upon request.
Timeline
Claims Examiner
Avera Health Plans
09.2014 - 01.2024
Accounts Payable Clerk
Sanford PFS
04.2003 - 12.2013
Bluecard Patient Representative Associate
Wellmark Blue Cross Blue Shield
07.1996 - 07.2003
Claims Processor
Wellmark Blue Cross Blue Shield
01.1993 - 07.1996
Watts
Wellmark Blue Cross Blue Shield
11.1987 - 09.1993
File Room Clerk
South Dakota Blue Shield
08.1984 - 11.1987
Executive Secretary Program
Nettelton Business College
High School Diploma -
Marion High School
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