Amy Gaines

Verified insurance benefits using online tools and phone calls, ensuring compliance with payor guidelines. Managed claim rejections and denials, taking ownership of unpaid and denied claims from start to finish within deadlines.

Performed mental health claim scrubbing, understood denials, and resubmitted denied claims. Conducted daily insurance collection calls and verified insurance benefits for potential clients.

Managed receiving and processing containers, and entered sales orders for manufacturers. Handled customer and sales representative inquiries via phone and email, resolving service or billing complaints.

Managed shipping and invoicing for orders, and communicated with sales representatives and the warehouse. Processed credit card orders and oversaw Canadian orders.

Resolved customer service and billing complaints, including exchanging merchandise or adjusting bills. Conferred with customers to provide product information, take orders, and handle account cancellations.

Managed data entry for job specifications to generate quotes and work orders, acting as a liaison between sales and production teams. Ensured quality control for every job and managed work in process reports to maximize efficiency.

Assisted the dentist with patients during treatment and performed administrative tasks at the front desk, including setting appointments. Managed marketing advertisements and cleaned equipment after use.

Grade: 4.0

Completed a fully accredited, accelerated program focused on medical billing and ICD-10, CPT, and HCPCS coding for diseases, surgeries, and medical procedures. Gained expertise in electronic health record (EHR) systems, accounting methods, and processes for preparing and submitting healthcare claims. Developed research, professional writing, critical thinking, and communication skills.

Acquired relevant skills critical in a business setting, including professional communication, corporate team building, and business analysis competencies. Studied industry-specific skills such as human resource management, risk management, and business processes.

Developed decision-making skills to deliver organizational value in dynamic environments. Created strategies for sustainable organizational success by integrating the organization’s mission and vision with societal values. Synthesized leadership skills to foster innovation and facilitate change in a dynamic business environment.

Gained a comprehensive background in areas such as sales, advertising, and retailing. Explored concepts including marketing research, marketing management, and international marketing.