Kristin Carlile is seeking a long-term job utilizing her extensive experience in healthcare settings including hospitals, doctors' offices, and insurance claims processing. She has strong skills in customer service, medical terminology, data entry, and computer programs like Excel. Her background includes processing medical claims, verifying patient information, and assisting with customer needs in various roles over the past decade.
Healthcare Claims Professional Seeking New Opportunity
1. Kristin Carlile
3721 Bardstown Road #402
Louisville, KY 40218
Kristin.lear@yahoo.com
Objective
With my vast knowledge of the healthcare industry, both in a hospital and office setting as well
as dealing with medical and third party claims I believe I am dually qualified for a multitude of
positions. This knowledge provides me with the confidence to perform my duties effectively and
efficiently. I am looking to find a long term job where I feel my presence can do the most good.
Summary of Qualifications
• Extensive customer service experience
• Front desk / receptionist expertise
• Knowledge of medical and insurance terminology
• Excellent written and verbal communication skills
• Goal oriented
• Familiarity with medical terminology and coding
• Ability to manipulate and update spreadsheets using Microsoft Excel
Work Experience
Copay Recovery Unit | Pharmerica 11/15-present
Responsibilities include verifying the low income subsidy level of residents who reside in long
term care facilities, call insurance companies to obtain copay reimbursement and excluded
medication information as well as contacting long term care facilities to collect evidence
following CMS guidlines to update our residents to a low income subsidy level 3.
Claims Processor | Firstsource 09/14-10/15
Responsibilities include determining whether or not incoming medical
claims should be paid or denied. Patient and treatment information must
be verified. By following state guidelines regarding treatment I am
able to determine whether or not the claim can be paid or must be sent
2. back to the provider for resubmission. If I am unable to make a
determination based on the information provided I am required to send
that claim to appropriate department for clarification or updates.
Client Account Specialist | RxCrossroads 05/14-09/14
Responsibilities include processing incoming orders, faxed, e-mailed and
phone; entering the order , verifying physicians’ license information,
checking for duplicate orders, insuring the order is shipped in a timely
fashions, managing my own account; communicating with customers/clients,
e-mailing/faxing order and account set up forms, running the
acknowledgement of receipt report, and verifying the accuracy of
co-worker’s orders.
Receptionist | Dr. Norman Radtke 11/13-01/14
Responsibilities include scheduling appointments and checking in
patients upon their arrival, collecting co-pays, entering insurance
information into MDOffice, filing and preparing patients’ charts,
scanning appropriate medical documents into EMR, and transferring
medical records to referring doctors.
Claims Processor | Trover Solutions 01/11-05/13
Responsibilities include investigating events, accurately verifying
accident details, and documenting incoming mail. Handling calls from
clients, members, insurance companies and attorneys.
Customer Service Representative | Trover Solutions
Responsibilities included handling calls for a variety of health
insurance clients, documenting correct claim and treatment information
into files.
Unit Secretary/Monitor Technician| Kosair Children’s Hospital 03/09-01/11
3. Responsibilities included clerical reception, admission, communication,
accurately transferring doctor’s orders into the computer system,
delivering medication, and assuring each employee had the appropriate
equipment.
Monitor Technician responsibilities included monitoring the heart
rhythms of patients, notifying nurses of rhythm changes, tracking
patient admission and discharge, and preparing a summary of the shift’s
activities.
Education
University of Louisville
December 2007
Bachelors in Arts and Sciences - English Major
Louisville Male High School
August 2003
Diploma- with a concentration in pyschology
References
Brad Wiseman- Trover Solutions- Customer Service Supervisor
502-214-5197
Sharon Fox- Trover Solutions- Claims Processor Supervisor
502-214-5183
Linda Clem- Firstsource- Quality Analyst
502-964-3497