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Van Colotti

@vancolotti

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Claims Resolution Specialist at Magellan Health processing behavioral health claims and resolving claim adjustments.

United States

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What I'm looking for

I’m seeking work in healthcare claims and billing, where I can use my experience in claims resolution, adjudication, appeals, and revenue cycle support.

At Magellan Health, I provide claims resolution and assist with claim adjustments for members, providers, and internal departments. I process CMS 1500 and UB-04 forms for behavioral health services.

At Kaiser Permanente, I adjudicated healthcare claims across commercial lines of business, some Medicare plans, Hospice contracts, and high-dollar complex claims. I interpreted provider contracts, fee schedules, and member benefit terms to determine reimbursement.

At Healthcare Resource Group, I prepared medical claims for submission, verified insurance, and researched denials and payment issues. I also prepared appeals and completed payment posting transactions.

Earlier, at Physicians Clinic of Spokane and Lincare Inc., I worked on patient accounts, insurance billing, coverage verification, claim corrections, and appeals. I bring experience in claims adjudication, medical billing, and revenue cycle support.

Experience

Work history, roles, and key accomplishments

Current

Claims Resolution Specialist

Current

Magellan Health

Oct 2024 - Present (2 years)

Provide claims resolution and assist with claim adjustments between members, providers, and internal departments. Process CMS 1500 and UB-04 forms for behavioral health services and ensure timely completion of assigned tasks.

Claims Resolution Claims Adjustment CMS 1500 UB 04 Behavioral Health Medicaid Claims Inventory Audit Corrective Actions

Claims Examiner

Kaiser Permanente

Jul 2017 - Mar 2024 (6 years 8 months)

Adjudicated healthcare claims for Kaiser Washington members and out-of-state members accurately and promptly. Processed professional CMS 1500 and institutional UB CMS 1450 forms for various lines of business.

Claims Adjudication CMS 1500 UB 04 Commercial Insurance Medicare Hospice Reimbursement Contractual Agreements Fee Schedules Audit Compliance

Insurance Billing Representative

Healthcare Resource Group

May 2010 - Mar 2016 (5 years 10 months)

Supervised assigned accounts in daily work queue for private/commercial, Medicare supplemental, and other government payers. Prepared medical claims for paper submission and assisted with electronic billing submission.

Medical Billing Insurance Verification Claims Processing Denial Management Appeals Cash Posting Payment Batches Medicare Commercial Insurance

Patient Account Representative

Physicians Clinic of Spokane

May 2009 - May 2010 (1 year)

Evaluated and collected on delinquent self-pay accounts. Answered phone inquiries from patients and outside parties, and made outgoing collection calls for assigned accounts.

Collections Patient Accounts Insurance Denials Claims Correction Appeals Billing Discrepancies Patient Demographics Customer Service

Insurance Billing Specialist

Lincare Inc.

Jun 2007 - Feb 2009 (1 year 8 months)

Monitored and collected accounts receivable for assigned payer groups. Prepared medical claims and submitted to insurance companies for processing, and worked monthly aging reports.

Accounts Receivable Medical Billing Insurance Claims Denial Management Appeals Coverage Verification Ageing Reports Medicare Commercial Insurance

Education

Degrees, certifications, and relevant coursework

John R. Rogers High School

High School Diploma, General Studies

1998 - 2002

Earned a High School Diploma from John R. Rogers High School in Spokane, WA, from 1998 to 2002.

Spokane Community College

Career Building Courses, Business

Completed career building courses in the Business Department, covering keyboarding, document processing, basic Microsoft applications, and business math.