Melissa Cochran
Nottingham,PA
Summary
Resourceful, self-directed support professional demonstrating pride in performance and successful work accomplishment. Strong customer service, problem solving, time management and organizational skills. Self-motivated, able to implement decisions and set effective priorities to achieve both immediate and long-term goals, sound decision-making and interpersonal skills.
Overview
26
26
years of professional experience
Work History
Insurance Coordinator
Albright And Thiry Orthodontics
09.2003 - Current
- Verify insurance coverage and eligibility
- Perform dental coding and billing tasks using current ADA codes
- Submit claims and process insurance payments/refunds
- Conduct detailed investigations into complex claim cases
- Oversee accurate insurance records
- Resolve any billing discrepancies or issues with insurance companies
- Provide assistance and support to patients regarding insurance/billing
- Generate and send invoices to patients in a timely manner
- Follow up on overdue accounts
- Ensure accurate insurance and demographic information
- Assist front desk with scheduling as needed
- Prepare and file financial documents
- Process accounts receivable
- Prepare office payroll and track payroll data
Insurance Processor
HealthGuard
06.2002 - 09.2003
- Determined eligibility, benefit levels, and coordination of benefits
- Processed complex medical claims in accordance with plan provisions
- Reviewed duplicates and possible adjustments
- Resolved system benefit issues by coordinating with internal departments
- Updated the doctor or insurer about changes needed to the claim
- Clarified patient concerns about benefits
- Maintained strong knowledge of basic medical terminology to better understand services and procedures
- Made sound decisions on claims in line with rules and guidelines
Claims Processing Specialist
Administrators And Consultants
08.1998 - 06.2002
- Entered patient information and medical claims data into the computer system
- Reviewed and verified medical claims for accuracy and completeness before processing
- Determined coverage by comparing patient records with insurance policy provisions
- Calculated the amount payable by the insurance company for each claim
- Coordinated with healthcare providers to obtain any missing information or clarification needed to process claim
- Rejected claims that did not meet the criteria of the insurance policy and explained the reasons for denial to the claimant
- Processed approved claims for payment ensuring timely disbursement of funds to healthcare providers or policy holders
- Maintained records of processed and pending claims including notes of any follow-up actions or investigations required
- Managed and processed large volumes of claims accurately and efficiently
- Stayed updated on changing healthcare regulations and insurance guidelines
Education
High School Diploma -
Solanco High School
06.1998
Skills
- Excellent customer service
- Written and verbal communication
- Detail oriented
- Highly organized and efficient
- Work well independently and as part of a team
- Computer literacy
- Ability to multi-task
- Strategic thinking skills
Timeline
Insurance Coordinator
Albright And Thiry Orthodontics
09.2003 - Current
Insurance Processor
HealthGuard
06.2002 - 09.2003
Claims Processing Specialist
Administrators And Consultants
08.1998 - 06.2002
High School Diploma -
Solanco High School
Similar Profiles
Tahar CHERGUITahar CHERGUI
Étudiant éducateur spécialsé en accompagnement ps at Lise ThiryÉtudiant éducateur spécialsé en accompagnement ps at Lise Thiry
Christopher MatthewsChristopher Matthews
Painter at Steve Schafer Painting/DBA Albright PaintingPainter at Steve Schafer Painting/DBA Albright Painting
Ashlee BallouAshlee Ballou
Office Administrator at Albright Roofing and ContractingOffice Administrator at Albright Roofing and Contracting