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Contact Number: (012)-345-6789
Email Address: [[email protected]]
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Career Objective:
To work as an appeals coordinator and provide satisfactory answers and feasible solutions to grieving patients and ensure quality medical care for them.
Summary of Skills:
- Comprehensive knowledge of medical terminology and health care customer service
- Familiarity with CPT/HCPC and ICD9 coding, guidelines and procedures
- Sincere, punctual, detail-oriented, and self-motivated individual
- Efficient at performing administrative and clerical functions
- Possess a sense of responsibility and high regards to ethical behavior
- Outstanding verbal and written communication
- Maturity to maintain confidentiality and healthy work relationships with patients and coworkers
- Ability to comply with Health Insurance Portability and Accountability Act (HIPSS)
Work Experience:
Appeals Coordinator
Columbus Redressal Forum, Columbus, OH
August 2013 – Present
- Make a note of the complaints registered against different hospitals within the city
- Evaluate eligibility of cases and admit suitable cases for evaluation
- Send compliant reports to hospitals and demand explanations for complaints registered
- Conduct investigations to check for negligence on part of medical teams
- Conduct meetings with both parties to find feasible solution for grievances
- Advise legal action against cases for medical negligence and billing mistakes
- Take suitable action against the offending members and provide compensation to grieving patients
Appeals Coordinator
Noble Hospital, Columbus, OH
May 2012 – July 2013
- Responded to complaints filed by patients and their family members and helped them understand the complexities
- Explained process of levying expenses and computation methods adopted to draft bills and justify final amount
- Made changes to figures in invoices in case of genuine overcharging or undercharging
- Reported cases of mistakes or negligence by medical staff to higher authorities
- Entered details of complaints and requests into computer systems and prepared documentation for further process
- Assured timely intervention and arbitration according to state and federal healthcare guidelines
Education:
-
Bachelor’s Degree in Business Management
Columbus University, Columbus, OH
2011
Reference:
On request.
