Candidate Information Title Medical Billing Customer Service Target Location US-FL-Port Orange Email Available with paid plan Phone Available with paid plan	20,000+ Fresh Resumes Monthly     View Phone Numbers     Receive Resume E-mail Alerts     Post Jobs Free     Link your Free Jobs Page     ... and much more Register on Jobvertise Free
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S H E L B YB U R D E T T EStreet Address  S Williamson BlvdPort Orange, FL Street Address
PHONE NUMBER AVAILABLEEMAIL AVAILABLESUMMARYSkilled professional in Clinical Admin UMR CPS Claim Platform certification ICD-9 & ICD-10 Analyze claims as well as follow Up Tech with over 10 years of experience in General Clerk II, behavior Management, youth education, and project Management. Proactively develop, streamline and energize projects, programs and other disciplines to reach company financial goal. Proven record of success communicating and interacting with clients, patients, physicians, and nurses.AREAS OF EXPERTISETeam building & LeadershipAdministrative & Caseload ManagementPrevention & Management of Aggressive BehaviorMicrosoft Office ProficiencyPublic Relations & Community PartnershipsResolve Customer Service InquiriesEmergency First Aid & CPR Level B (Adult, Child & Infant)Respond to Incoming Provider & Enrollee callsInterview, Assessment & NegotiationProvide Excellent Customer Service to both Providers & EnrolleesRegulatory Compliance Mentor others multitaskEMR Systems, EPIC, FIN, NextGen, & AmiysisOrganization & Time ManagementGovernment Claims Biller/ Follow Up TechPayroll Specialists using Kronos systemICD-9 / ICD-10 Coding CertificateEDUCATION & TRAININGDEGREESCHOOLDATEDiploma- Nursing AsstStratford Career InstituteMarch 20, 2008Bachelor- Health care AdminUniversity of PhoenixCompletion December 2019/ OnlineCertificate- ICD-9/ ICD-10Baylor Scott and White CourseOctober 2015PROFESSIONAL EXPERIENCEDATES FROM: August 2014 May 2019Senior Clinical Admin Specialist-Claims Audit Rep / Baylor Scott and White/ Temple, TXReceives Care Coordination notification cases for non-clinical assessment/provides appropriate triage.Set up/ documents/ triage cases for CCR Medical Claims ProcessingProcesses letters within DOL time frame and Assist with faxes/ emailsProcess medical, commercial, and workers comp claims UB & 1500 claim formsProvides clinical admin support the inpatient clinical team. Verifies appropriate ICD-10 and CPT coding usageAppealed claims/ denials and forward to appropriate provider for processingModerate work experience within own function as well as Mentors othersManage incoming clinical information from providers. Basic tasks are completed without review by othersMaintained a high level of data integrity and compliance. Other duties as assigned by manager and/ or directorEducated patients for home care and discharge planning.Respond to all fax requests as well as medical terminology and medication administration skillsCash posting payments for provider /patient as well as adjustments posted to acctPerforms Follow-ups Reviews for operational and Admin support to the departmentUtilize appropriate literature to educate others on development of leadership skillsDevelop strong relationships; mentor and support employees with any concernsContacted patients and insurance company representatives by telephone or through internetDATES FROM: 09/2010 TO: 07/2014Health care Admin/ Medical Claim Specialist / Hill Country Home Health care/ Harker Height, TXInputting patients insurance into the database system, and Medical Receptionist DutiesReceiving patients, insurance/ billing, EMR records, charted and documented activitiesMeet weekly provider contact goals and provided excellent customer serviceSchedule patients appointmentsPerformed collection activities for all/assigned accountsDATES FROM: 06/2002  TO: 11/2006Medical Admin Asst / Southwest Hospital/ Atlanta, GAProvided care to patients under the direction, and supervision of the physicianAsst the Credentialing Team by performing site visits/ surveys as neededCollection of patient data, Medical Billing Coding, EMR records, and diagnosticsBasic tasks are completed without review by othersSome work is completed without established proceduresREFERENCESNAMEEmailJOB TITLEMelissa MartinEMAIL AVAILABLEHealth care AnalystMyra MedianEMAIL AVAILABLERegional ManagerBryon PhillipsEMAIL AVAILABLEMaster Sgt/ ARMY