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Click here or scroll down to respond to this candidateCandidate's Name
EXPERIENCEDecember 2014-July 2016Medical Claims Specialist Veterans Affairs Financial Services Utilize the VA-FSC medical claims processing system which incorporates an Internet authorization application, document processing functionality, optical character recognition (OCR) scanning capability and Plexis Claims Manager (PCM) claims processing software. Input and validate medical claims data into the PCM application. Analyze rejected claims data. Review documentation authorizing benefits payments. Determine appropriate amount due to recipient and process all necessary payment transactions. Analyze and audit any overpayments of claims. Record and issue letters informing debtors of obligations. Respond to written and oral vendor inquiries; follow up as needed. Justification submitted must be in compliance with CPT, HCPCS and ICD-9-CM and ICD-10-CM standards. Review claims for completeness and accuracy.Aug 2016-Dec 2018Patient Representative Community Caretaking measures to ensure patient care is delivered safely by following appropriate procedures for inventory management, cleaning of clinical equipment and the care environment while following all patient safety guidelines, protocols, and procedures;completing standardized clinical questionnaires and templates within the scope of training and applicable guidelines( 2 months of training was required).ensuring that patient privacy is protected by complying with all information security and patient privacy regulations. receiving and scheduling requests for simple and complex intra-facility, and inter-facility telehealth appointments using an electronic resource-based scheduling system. screening patients for Telehealth modality and referring patients that do not meet established criteria to appropriate care. providing patient education via approved materials.Jan 2019-July 2022Patient Access Representative R1RCM/Ascension Seton Screened incoming contacts and independently routed the contacts to the appropriate area for resolution. Used knowledge and resources of the health care process as it relates to our care provided for efficient check-ins. Utilized various software, hardware system products, and data portals to 440 Bunton Reserve Blvd,Kyle, TX 78640PHONE NUMBER AVAILABLEEMAIL AVAILABLEhttps://direct.me/amberhumphriesYou may not control all the events that happen to you, but you can decide not to be reduced by them.Maya AngelouOBJECTIVEI want to use mycreativity, andinterpersonal skills whilemaking significantcontributions, and gainingnew skills and experienceswith a growing company.transfer and capture information electronically to support the unit's daily operation. Provides high-quality customer service to patients and their loved ones. Used proper protocol and communication effectively to challenge customers who may be threatening, abusive, or distraught. EDUCATIONPRAIRIE VIEW A&M UNIVERSITY Bachelor of Science in Nursing Studies 2013-2015 CONCORDIA UNIVERSITY TEXAS Bachelor of Science 2016-COMMUNICATIONI have honed my communication skills through years of experience in verbal and written communication with clients, vendors, and team members. I hope to be a safe space for my team members and encourage vocalism while beingprofessionally transparent in my delivery of presentations, business updates, and overall team communication. I want to promote effective communication throughout my team for clarity, consistency, and discourse.LEADERSHIPI have displayed strong leadership skills in managing a team of administrative staff and supervising daily operations. I have experience in providing guidance and support to staff, setting performance expectations and providing feedback, and addressing issues as they arise.ACTIVITIES & INTERESTSSIGMA TAU DELTA INTERNATIONAL ENGLISHHONOR SOCIETYConcordia University Texas 2016 Treasurer, 2017 Vice President, Head of FundraisersSIGMA GAMMA RHO SORORITY INCORPORATEDMu Beta Sigma 2016 |
