MARINA MANN5717 Mango Lane, Hilliard, Oh 43026(614) 402-1789
[email protected]
SUMMARY
Bi-lingual business professional with over 9 years of experience
in Hospital and Professional claims, appeals, customer service and
follow up, bringing qualities such as high work ethic, accuracy and
excellent customer service to the job market. Profound
understanding of UB04 and HCFA1500 billing structure, CPT and ICD9
coding and federal guidelines pertaining to health insurance
industry Brought additional revenue to large medical teaching
facility
PROFESSIONAL EXPERIENCE
The Ohio State University Wexner medical Center Columbus, Ohio
July2012 to present
PATIENT REVENUE CYCLE SPECIALIST
To review and follow up outstanding medical claims with various
insurance companies in order to receive maximum reimbursement
Heavy phone contact with insurance companies.Review all claims
for correct payment through diagnosis & procedure codes within
individual contracts and medical guidelines.Contacting the
insurance carrier and/or member to resolve any outstanding
issues.Maintain and manage accounts with proper file management
techniques.Send appeal correspondence for certain claims to
insurance carrier. Performs related duties or special projects as
required
Aetna, New Albany, Ohio June 2010 to July 2012
CLAIM BENEFITS SPECIALIST
Process hospital and professional Medicare Advantage claims.
Review and adjudicate routine claims in accordance with Medicare
claim processing guidelines.Apply medical necessity guidelines,
determine coverage, complete eligibility verification.Increased
productivity with excellent accuracy. Got nominated for Peer to
Peer award
The Principal Financial Group, Columbus, Ohio January 2006 to
March 2010
MEDICAL CLAIMS EXAMINERProcessed hospital and Professional
medical claims according to specific benefits plans. Made
appropriate decisions based on various contracts and plan
provisions which included evaluation of claim per plan provisions,
determination of eligibility, identification of correct benefit
level, calculation of fee schedule and making corrections. Ensured
correct payment of claims, using multiple resources to increase
productivity.
Reduced errors of payment of claims by investigating claim
history, increasing accuracy and identifying the need to adjust
mistakes.
Consistently paid claims in date order with high quality
results.
Answered customer service calls from providers, members and
agents.
Limited Logistics Services, Columbus, Ohio May 1999 to January
2006
MERCHANDISE PROCESSORSorted wholesale products received to
prepare for shipment to customers. Handled special orders for
customers. Worked in teams to conduct inventory control of
warehouse
Trained and mentored employees on operation on new warehouse
management system.
Assist, Dublin, Ohio January 2003 to January 2004
INTERPRETERAssisted in establishing accurate communication
between medical personal and patient.
EDUCATION
BRYMAN INSTITUTE, Gahanna, OhioMedical Billing and Coding
Certificate GPA 4.0Completed course in August 2005
Moscow University, Moscow, RussiaMajor in English as second
languageGraduated in 1992
