MELISA MADSEN

232 E Louis Ave, Salt Lake City, UT 84115 - mxmadse@gmail.com - Mobile: (775) 772-3619

PROFESSIONAL EXPERIENCE University of Utah January 2013 to present Customer Service Rep/Medical Claims Processor I am currently able to keep accuracy above 98% in my claims processing, and always process claims in a timely manner. I also maintain 100% accuracy in my customer service audits, which reflects professionalism and staying up to date on changes with benefits. Process claim forms, adjudicate for allocations of deductibles, co-payments, coinsurance maximums and provider reimbursements. Provides prompt customer service to members, providers, billing departments, and other insurance companies regarding claims and benefits. Documents phone calls in system and follows up on issues if needed. Enters claims data into system while interpreting coding and understanding medical terminology in relation to diagnosis and procedures. Resolves problems resulting from claim adjudication and customer service phone calls. Regence Blue Cross Blue Shield March 2004 to March 2012 Claims Analyst I & II During this position I multitasked between many different job functions, always exceeded the standards for timeliness and accuracy, and would help train new team members on department processes. Entered claims, generated medical records requests and forwarded requests to correct departments. Corrected pending claims requiring research and resolution and adjusted resubmitted claims. Reviewed claims for payment and evaluated appeals. Coordinated with providers by multiple methods to solve unresolved claims.

Conducted outbound research for other departments regarding missing claim information. EDUCATION General Education, Salt Lake Community College January 2012 to present Medical Billings and Insurance Coding MOUNTAIN W EST COLLEGE Salt Lake City, UT August 2003 to September 2004 References available upon request