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Click here or scroll down to respond to this candidateCandidate's Name
Street Address Linden CircleHuntington, WV Street Address
Cell: PHONE NUMBER AVAILABLEEMAIL AVAILABLECareer FocusLooking for a position that will utilize the skills and experience I already possess, as well as allow me the opportunity tocontinue learning.Summary of SkillsCustomer service Medical terminologyStrong organizational skills Compensation/benefits administrationListening skills Recruitment/staffingClaims Data Entry InterviewingMS Windows proficient Strong verbal communicationAttention to detail File/records maintenance/archivingEmployee training and development Reports generation and analysisBusiness correspondence Quality assuranceInsurance Claims Adjudication Policy/program developmentCurrent Procedural Terminology (CPT) International Classification of Diseases (ICD.9CM)HCFA Common Procedure Coding Systems (HCPCS)Accomplishments Computer Proficiency Created PowerPoint presentations that were successfully used for business development Database Maintenance Assisted in the managing of the company database and verified, edited and modified members'information. Process Improvement Created new departmental procedures manual. Assessed organizational training needs.Professional ExperienceRadiology ReceptionistCabell Huntington Hospital, Huntington WV February 15, 2021 to Present.Check in Radiology patients, provide reports and images to patients/ providers/facilities, schedule patient appointments, etc.Admin Staff SupportElwood Staffing/Memorial Hospital Colorado Spring, CO June 22, 2015
May 2020 Onboarding Traveler individuals, posting positions, job offers, tracking compliance requirements to ensure that allrequired documents are present (i.e., licenses, health exams), create and maintain spreadsheets of current and pastTravel individuals, New Hire Orientation, assist with ShiftWise employer tracking system questions, generate reportsfor upper management, act as liaison with hiring agencies, etc.Manager Provider Data December 2012 toJuly 2014HMSA Honolulu, HI Manage a staff of 16 employees with the Provider Data Unit. Update and add new providers record into the companies4 database systems, complete employee performance evaluations, draft documents for system enhancements, respondto provider and other departments inquiries, act as department representative in projects and policy changes, etc.Legal Secretary November 2010 toDecember 2012Mohave County Criminal Justice Services Kingman, AZ Prepared motions & briefs for filing in Courts for Appellate Defender, open & distribute case assigned to the PublicDefender's office, enter billing data for legal cases administrative support to Appellate Defenders and Criminal JusticeDepartment, prepare contracts for contracted Public Defenders, telephone duties, filing, etc.Program Service Evaluator, III January 2007 toJune 2010State of Arizona Kingman, AZ Determining eligibility for State Medical, Food Stamp & Cash Assistance benefits. Explain & follow State &Federal regulations, customer service, computer file entry & maintenance, assigned hospital worker - collectmedical applications, interview clients & disseminate applications to proper offices, format cases for scanninginto database system.Administrative Assistant/HR Technician February 2004 toNovember 2006City of Kingman Kingman, AZ Human Resources - recruitment, new hire paperwork and orientation, training & presentations, COBRA & FMLAtracking, benefits enrollment and administration, salary surveys & employment verifications, insurance billingreconciliation and payment, payroll. Administrative Assistant in City Clerk's office- disseminating information to the Mayor, Council, staff, general publicand other agencies on City programs, activities and policies; business license application review and approval process;City elections; records and computer file maintenance; development of flyers, newsletters, agendas, and minutes;clerical support; customer service; assist Human Resource Department with reference verifications and interviewscheduling, flyers, job postings and advertisements, advertisement tracking and payment authorizations, assist withHealth fair, assist with luncheon preparations, bank deposits, etc.Safe Home Network Coordinator July 2003 toFebruary 2004Interagency Council Lake Havasu City, AZ Safe Home Network Coordinator, plan and coordinate training sessions and monthly meetings, filing, databaseentry, typing, written communications, case manage clients in transition housing, develop flyers and pamphletsfor education/information purposes, appointment scheduling, educational presentations, work with internal andexternal departments, public groups and governmental agencies, etc.MIS Database Administrator February 2001 toApril 2003State of Montana Helena, MT Manage and operate the job training participant information database; provide programming and support services;training and policy direction to approximately 28 service providers statewide and two local workforce investmentareas; analyze and screen data to identify aberrations or potential problems with the date; generate reports to theUS Dept. of Labor, Governor, legislature, state and local workforce investment boards, public, and service providers;provide training and technical assistance to internal and external customers regarding federal and state laws,regulations, program functions, goals, etc.Call Center Representative/Supervisor February 1999 toFebruary 2001New West Health Services Helena, MT Answer benefit questions; address claims problems; supervise call center workflow; system testing; new productreview and implementation; presentations; policies and procedures development, updates and revisions; claimsauditing; work with internal and external departments, public groups and governmental agencies; provide training tointernal and external entities; maintain employee files and yearly evaluation assessments; reporting inventory andproduction statistics; payroll time sheet verification; employee counseling; and disciplinary actions.Administrative Assistant / Phlebotomist January 1998 toFebruary 1999St. Patrick Hospital Missoula, MT Patient registration; front office reception; order laboratory tests; print and distribute laboratory reports; writecompliance policies; deliver lab results to physician offices; receive telephone laboratory orders; phlebotomy; EKG's,etc. .Family Support Officer January 1997 toJuly 1997Butte County Family Support Office Oroville, CA Locate, request and conduct interviews relating to child support services; resolve questions of paternity; negotiateagreements for support payments; correspond with a variety of governmental and private agencies; obtain facts andprepare cases for submission to investigators/attorneys for potential prosecution; read, interpret and explain lawsand regulations pertaining to family support services; generate legal documents; provide testimony in court, etc.Medicare Blue Shield of California Chico, CASeptember 1982 to November 1996 Entry of claims into processing system; examining claims for completeness; develop for missing information andreview diagnoses to determine payment and deny non-payable services. Audit claims processed for accuracy and completeness; conducted training classes for new and promoting employees;special projects (i.e., writing of RFPs, development of interim guidelines for problem situations, assist with the testingof new systems, etc.); assisted supervisors; and developed and implemented the alternate claims processing shift. Managing the workflow of 13 to 30 processors to maintain productivity and timeliness; maintain employee filesincluding quality and production records and yearly evaluation assessments; daily reporting of inventory andproduction; payroll time sheet verification and submission; employee counseling and disciplinary actions; reviewproduction standards; dealing with system problems; Medicare Bulletin review; development of desk level proceduresfor HV transactions and batch control, etc. Train new and promoting employees into processing functions; guideline clarification; update processing manuals;review Medicare Bulletins and Special Notices for content and clarity; teach medical terminology; assistproviders/beneficiaries with billing questions and/or claims problems; developed and implemented the ConsistentAuditing Program, etc. Monitor provider billings to ensure compliance with government regulations; research cases using CRT/MDT/Micro-fiche readers and PCs; train new employees in the unit; supervise employees in the absence of the unit supervisor;special projects (i.e., Common Working file proposal); internal/external presentations regarding the functions of theProvider Monitoring Department and annual budget preparation. Supervise 14 analysts and assistants; research and develop potential Medicare fraud and abuse cases; work withinternal and external departments/public groups/and governmental agencies (i.e., OIG, HCFA; FBI; providers andbeneficiary communities, etc.); provide expert testimony in trials and hearings; provide training to internal and externalentities; maintain employee files and yearly evaluation assessments; reporting inventory and production statistics;payroll time sheet verification; employee counseling and disciplinary actions; Medicare Bulletin review; developmentof desk level procedures manual for PSU functions; participated as the fraud authority at provider/beneficiary seminarsfor Northern California Medicare and annual budget preparation.EducationButte Community CollegeOroville, California, USWildlife Biology |
