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Reconciliation Specialist ensures that companies are in compliance with all government Medicaid and Medicare program rules and regulations. Analyzes data, uses accounting software and records conclusions after researching database. Specializes in Medicare guidelines, rules and laws.
Spoken and written communication skills
December 2007 to June 2008 Aetna Insurance Company – Deep Down Muddy River, AL Reconciliation Specialist – Reviewed medical claims for discrepancies. – Read through an average of 45 Medicaid insurance claims per day. – Prioritized, organized and filed insurance claims based on dollar amount. July 2008 to April 2011 Golden Horizon Medicare Payments – Deep Down Muddy River, AL Reconciliation Specialist – Used cost accounting theory to compare insurance claims. – Completed average of 82 medical claims per day. – Supervised team reconciling problems with different insurance forms. July 2011 to June 2014 Medical Payment Systems of Deep Down Muddy River – Deep Down Muddy River, AL Reconciliation Specialist – Researched membership discrepancies for prescription drug programs. – Found $2 million in fraud. – Followed all government medical program rules, guidelines and laws.
2007 Alabama Institute of Technology, Nirvana, NE Bachelors, Business Administration