AIDA A. FRASER
Hamilton,Canada
Summary
Professional with robust background in claims assessment, skilled in analyzing and evaluating complex information to support accurate decision-making. Strong collaborator, reliable in adapting to changing needs, and focused on achieving results. Expertise in data analysis, risk assessment, and compliance, combined with excellent communication and problem-solving abilities. Known for high standards and delivering impactful outcomes in team environments.
Overview
39
39
years of professional experience
Work History
Medical Claims Assessor
Ministry of Health and Long-term Care
01.2007 - 01.2014
- Process and correct incoming claims using Online Claims Correction System
- Process inquiries and adjustments using automated adjustment program (ACA)
- Interpret coding from patient history
- Research, investigate, solve complex claims (OCCS, REG, PCN, MCP screens)
- Create physician advances as per manager's request using KPAS
- Respond to inquiries from providers and public from the phone and or e-mail
- Extract medical data for lawyers using Maple software (LES)
- Process ODB Claims (Pharmacy claims), SAA's (claim reversals)
- Assess claims over $1,000
- Research and investigate/correct problem claims
Data Processing Technician
Ministry of Health and Long-Term Care
01.1987 - 01.2007
- Process physicians' claims submission diskettes using MCON4 software
- Print reports and submit errors to Technical Services
- Perform file transfer protocols according to Ministry standards
- Create and process remittance advice (RA) diskettes for physicians, check that file and label match, mail diskette out to physician
- Process stale date claims
- Check TSO to see if runs are processed by Kingston Head Office
- Format diskettes for re-use, remove labels and put in appropriate trays
- Process CDE (Claims Data Entry) runs and perform file transfer ensuring file is received in Kingston
- Process IMAC (MacIntosh HD) claims submission diskettes for physicians, create RA at beginning of month
- Process re-create diskettes upon request for providers
- Respond to errors or system problems/failures
- Respond to telephone enquiries
- Pre-stuff envelopes and prepare for next months' RA processing and mailing
- Enter daily activity totals into CPU spreadsheet using Excel
Data Entry Clerk
Ministry of Health and Long-term Care
01.1982 - 01.1987
- Input physician/patient information from claim cards using a computer terminal
- Verify records for accuracy
- Occasional back-up supervisor to ensure target quotas were met
- Occasional work as Control Clerk
- Respond to telephone enquiries
Other/Occasional Work
Various
01.1975 - 01.1982
- Part-time positions: 1) Flamboro Downs-seller/cashier/waitress 2) Hamilton Convention Centre-bartender 3) Driving Instructor-self venture 4) Agency work- assignments to various companies-clerical, reception 5) Call centres-Sears Canada, Protocol-both sales orientated positions
Clerk Typist
Abstainers/Maplex Ins. Co.
01.1979 - 01.1980
- Type home/auto insurance policies, proofread and mail, occasional supervisory duties, occasional typing in claims adjuster area
Cashier/Bartender
Swiss Chalet
01.1978 - 01.1979
- Bartender, cash handling of food orders, occasional hostess duties
Snr. Accounts Payable Clerk
Union Electric Supply Co. Ltd.
01.1975 - 01.1978
- Ensure payment of suppliers' invoices and compile expense lists
- Occasional purchasing and pricing, physical inventory at year end
- Process monthly statements
- Other duties included typing, reception, P&L (profit and loss) on consignment orders
Education
Diploma - Human Resources Management
Mc Master University
Hamilton, ON06.2002
Graduate Certificate - Administrative Management
Mc Master University
Hamilton, ON06.1988
High School Diploma -
Sir JA Mc Donald Secondary School
Hamilton, ON06.1975
Certificate - OHIP Medical Billing
Mohawk College of Applied Arts And Technology
Hamilton, ON04.2014
Some University No Degree - Financial Accounting
Mc Master University
Hamilton, ON09.2006
Skills
- Professional ethics
- Documentation review
- Assertiveness
- Policy interpretation
- Claims processing
- Verbal communication
- Data verification
- Disability claims process
- Investigative skills
- Teamwork
- Customer service
- Problem-solving
Languages
English
Full Professional
Timeline
Medical Claims Assessor
Ministry of Health and Long-term Care
01.2007 - 01.2014
Data Processing Technician
Ministry of Health and Long-Term Care
01.1987 - 01.2007
Data Entry Clerk
Ministry of Health and Long-term Care
01.1982 - 01.1987
Clerk Typist
Abstainers/Maplex Ins. Co.
01.1979 - 01.1980
Cashier/Bartender
Swiss Chalet
01.1978 - 01.1979
Other/Occasional Work
Various
01.1975 - 01.1982
Snr. Accounts Payable Clerk
Union Electric Supply Co. Ltd.
01.1975 - 01.1978
Diploma - Human Resources Management
Mc Master University
Graduate Certificate - Administrative Management
Mc Master University
High School Diploma -
Sir JA Mc Donald Secondary School
Certificate - OHIP Medical Billing
Mohawk College of Applied Arts And Technology
Some University No Degree - Financial Accounting
Mc Master University
Similar Profiles
Mandeep Singh Toor WIN:440587Mandeep Singh Toor WIN:440587
Business and Fiscal Planning Lead at Ministry of HealthBusiness and Fiscal Planning Lead at Ministry of Health
Cynthia CoeCynthia Coe
PMHNP - BC at Orlando Psychiatric Associates & Behavioral HealthPMHNP - BC at Orlando Psychiatric Associates & Behavioral Health
KELLY MAIKELLY MAI
Licensing Associate - Student Placement at Ministry of Long Term CareLicensing Associate - Student Placement at Ministry of Long Term Care