Monique Morris
Lutcher,Louisiana
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
17
17
years of professional experience
Work History
Claim Specialist I
Blue Cross Blue Shield Of Louisiana
04.2023 - Current
- Reviews, researches, and makes necessary updates to claims that may include the following: recalculation of benefits to previously processed claims, the processing of claims edits, or initiation of refund requests, according to contractual benefits or provider reimbursement rules, ultimately providing a high degree of customer satisfaction.
- Achieves and maintains a clear understanding of all systems, applications, and procedures necessary to identify denial codes, edits, and processing codes pertaining to all claims (including our coordination with additional coverage plans) in order to process both coordinated and non-coordinated claims correctly
- Review quality audits for correction or routing within 48 hours of receipt following departmental and corporate guidelines to ensure accuracy of claims processing and customer satisfaction.
- Researches, investigates, and determines the correct order of benefits for payment to be made by the applicable plans and makes necessary corrections to COB records.
Patient Account Representative 2
Franciscan Missionary Of Our Lady Health System
10.2009 - 03.2023
- Worked with outside entities to resolve issues with billing, claims and payments.
- Posted payments and processed refunds.
- Contacted insurance to discuss referrals & authorizations
- Reconsideration and appeals sent to insurance
- Electronically submitted bills according to compliance guidelines.
- Monitored flags and resolved urgent items with accuracy and efficiency.
- Utilized computer programs to create invoices, letters and other documents.
Revenue Cycle Specialist
Urgent Care Billing And Collections Of America
12.2006 - 01.2009
- Identified and resolved payment issues between patients and providers.
- Contacted responsible parties for past due debts.
- Reached out to insurance companies to verify coverage.
- Balanced and reconciled accounts.
- Generated receivables reports and offered improvement recommendations.
- Followup on denied claims
Education
Medical Office Computer Specialist
Ascension College
Gonzales, LA06.1996
Skills
- Coverage Assessments
- Documentation Review
- Compliance Management
- Eligibility Determination
- Skilled in Microsoft Word, Excel, Powerpoint, Outlook, Teams
- Claims Processing
- Denied Claims Identification
- Prior Authorization Processing
- Excellent Administrative Abilities
- Medical Terminology
- Attention to Detail
- Teamwork and Collaboration
Timeline
Claim Specialist I
Blue Cross Blue Shield Of Louisiana
04.2023 - Current
Patient Account Representative 2
Franciscan Missionary Of Our Lady Health System
10.2009 - 03.2023
Revenue Cycle Specialist
Urgent Care Billing And Collections Of America
12.2006 - 01.2009
Medical Office Computer Specialist
Ascension College
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