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Click here or scroll down to respond to this candidateCandidate's Name
Street Address , USA PHONE NUMBER AVAILABLEEMAIL AVAILABLEPROFESSIONALPROFILEAccomplished professional with a comprehensive in Healthcare plans and online banking. Accustomed to dealing with data that is sensitive and confidential in nature. Organizes and prioritizes task assuring the timeframe will meet business needs, operational directives, and maintain high levels of accuracy.COMPUTER SKILLSProficient in Microsoft 360 Word Excel PowerPoint Out Look Practice Management Medical billing and Coding Medical Term type 45 WPM proficient in all Platforms in Social Media, Facebook, Twitter, Instagram, LinkedIn and YouTubeKEY QUALIFICATION Understanding the importance of misleading and uniformed information to the public Building professional relationships with my colleagues and clients Naturally creative researcher with writing skills related to factual information I have Innovative attitude while embracing new, ideas challenges and take ownership I am analytical, technically proficient and excellent communicator I have a strong customer focus setting high standards in quality controlEDUCATIONUniversity of Phoenix- Supply Chain Management/ Healthcare- 2018-2019Ultimate Medical Academy- Medical Billing and coding- 2014-2015Study at Community College of Allegheny County, Pittsburgh, PA. Liberal Arts,1983ExperienceMindlance /AmeriHealth Caritas Jacksonville, FL 2019-2020 Customer Service Representative / ContractedSupporting members with Updating demographics ( PHI) per HIPPA lawsResearching and assigning new PCP providers, Informing members of preventive care screenings and setting appointmentsUpdating Third party Insurance and Coordination of BenefitsAssisted Providers with claim status verified ICD 10 and CPT codes,Assisted Pharmacy with Utilization Management request and referralsAmazon-Jacksonville, FL..Fulfillment Associate/ Supply ChainReceived and understand work orders to determine the qualityCollaborating with all department including sourcing, procurementFocus on the expectation of high quality, flexibility, high service levelsFamiliar with the digitalization of logistics, EPA technologyGeneral Dynamic Technology, Lynn Haven, FL 2015-2115Customer Service-Open Enrollment-4 months ContractedConsulted clients on all insurance plans for their healthcare needsVerified immigration status on Visa, and I9s for international membersReviewed members on financial responsibility, deductible, co-insurance, and co-payment information for preferred providersMerritts Accessories 2008-2011 Owner & Jewelry Designer- Louisville, KYStore Buyer / Coordinated Mannequin DisplaysConsulted customers on clothing brands to promote sales in men and womens clothing increasing sales 30% in one monthManaged store account payable and receivableTrained all new employees and staff membersHumana Insurance 1998-2008 Medicare Compliance Analysis/ Account Executive Louisville, KyEnforced Federal Medicare Rules/Regulations and HIPPA lawsReviewed Sales and Marking documents for accuracy prior to publishingModified contracts and reviewed new provider credentials applying for new insurance lines of business for Medicare, Humana PPO, HMO and POSReviewed documents prior to presenting to stakeholders for approvalFlorida Blue/ Guildwell Contract -2 monthsProvider Advocate / Jacksonville, FlAssisted Providers with online inquires through the Availity messaging portal and phone calls. Providers submit inquires spreadsheets daily for information to be researched due to billing and coding issues, or medical records review. Navigating several systems Diamond, Siebel, Customer Connect, and accessing patients medical records.Knowledge of: Billing and Coding, Payment and processing of claims, Denial reason code if the claim was denied.,* |
