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Click here or scroll down to respond to this candidateCandidate's Name
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Street Address -2017: Cognizant Information Technologies
Medicare Claims Examiner Adjudication Data Analyst: Processing Medicare / Medicaid Outpatient, COB, APC, Vendor Professional Medical claims on QNXT 4.7 system for varies states also worked HIPAA Claim Master 837 system and DOMA through Citrix for Veterans Administration Patient-Centered Community Care working PC3 and VACAA CMS 1500, UB04 claims, understanding and experienced with ICD10, CPT, HCPC Coding, HC360, ePremis, MediAR, ECM, DIA and medical terminology. Write up and submit training guidelines for future use to maintain accuracy and standards. Enrollment Data Validation Analyst for Centene Healthcare Medicare with primary focus on enrollment, including Finance paid through date, Premium Paid through Date, Claims paid through date, updating financial status, applying bad debt, and ensuring that UMV has corrected information. Traveling Qxnt 5.1 trainer / SME and analyst for Medicare Medicaid based in Los Angeles. Evaluate employee retention of Qnxt subject matter and provide training in a classroom setting and side by side. Run daily reports of errors and edits; provide configuration team with analysis trends on edits and errors. Met established and documented quality and productivity goals, productivity targets and accuracy as set & communicated by management. Ensuring that work is completed in accordance with established procedures and standards on time attendance and no Events or Occurrences.
2012 to 2013 - Claims Coordinator @ Matrix Absence Management. Initiated and processed incoming claims for Family Medical Leave Act (FMLA), Long Term Disability (LTD), Short Term Disability (STD) and Workers Compensation (WC) claims.
2011 to 2012 Billing Claims Specialist @ Global Water Management. Processed and reviewed incoming billing claims, processed refunds, assigned work orders, dispatched technicians for emergencies for the cities of Maricopa, Surprise, Buckeye, and Red Rock in Arizona. And Torrance, Menlo Park, Covina, Grass Valley in California.
2011 to 2011 Tricare/Triwest Benefits Representative. Processed authorization and referrals for patients, answered general queries about benefits available from Department of Defense Health Plans, obtained Department of Defense security clearance.
2010 to 2011 CSR for Arizona Public Service Electric Company. Processed electrical turn on s, turn off s, transfer of service, deposit requirements, Billing inquiries, complaints.
2006 to 2009 Sr. Administrative Assistant @ DeVry University, in the Biomedical Engineering Dept. Scheduled and performed quarterly maintenance on medical, computer, engineering equipment across entire Phoenix DeVry campus, Networked systems, Troubleshoot technical issues regarding hardware and software while attending as student in biomedical engineering life sciences program.
Proficient in Microsoft Office, Excel, Word, Powerpoint, Peachtree, Qnxt, QuickBooks Pro, Oscilloscope functions, Function Generators, Hardware computer repair skills, 30 WPM, 10 key
Certified Phlebotomist, 1991 from Maricopa Community Colleges. Biomedical Engineering Technology student 2006-2009 3.9 GPA |
