Tarisa Weatherred
Liberty Hill,TX
Summary
Certified Medical Office Administrator. I have extensive experience in medical office procedures and policies. Hands on experience entering Insurance Biller and Coder information
Overview
26
26
years of professional experience
1
1
Certification
Work History
Claims examiner
Boon Chapman
06.2020 - 09.2024
- Processed paper claims and electronic work queues, including complex CMS 1500
- Processed claims that needed to be reworked
- Data entry of claim information
- Entered data and processed claims for direct member reimbursement
- Adhered to HIPPA compliance policy and procedures and regulations
- Maintained production and claims quality
- Worked various daily reports as needed by management
- Ensured all work and projects completed accurately and efficiently
- Researched professional claims to see if refunds were due to health plan
- Research and implement current Medicare procedures
Claims Examiner
Silverback TPA
Fort Worth, TX
01.2017 - 07.2019
- Processed paper claims and electronic work queues, including complex CMS 1500
- Processed claims that needed to be reworked
- Data entry of claim information
- Entered data and processed claims for direct member reimbursement
- Adhered to HIPPA compliance policy and procedures and regulations
- Maintained production and claims quality
- Worked various daily reports as needed by management
- Ensured all work and projects completed accurately and efficiently
- Researched professional claims to see if refunds were due to health plan
- Research and implement current Medicare procedures
- Laid off
Full-time Student
New Horizons Computer Learning Center
Fort Worth, TX
01.2016 - 04.2016
- Obtained experience processing of confidential information relating to the patient's demographics and medical information file, law & ethics, accuracy of source documents, bookkeeping and banking practices in the medical office
- Hands-on experience with all coding rules associated with Evaluation & Management, Anesthesia and a portion of surgery sections of the CPT coding
- Gained further familiarity with ICD-10-CM Codes, V & E Codes, Hypertension & Neoplasm tables, Tables of Drugs and Chemicals; and learned how to code using todays coding systems associated with Surgery, Radiology/Lab, and Medicine
- Memorized the primary anatomy and basic physiology of the entire body system, including disease processes and diagnostic procedures
Claims Benefit Specialist
Aetna
Arlington, TX
01.1999 - 06.2014
- Worked directly with members, doctors and employer groups, providing advice on the resolution of claims
- Trained coworkers on dedicated accounts
- Data entry of claim information
- Processed paper claims and electronic work queues, including complex CMS 1500 & UB04 in accordance with company policies and procedures
- Reprocessed claims that involved various contract issues, member claims involving all types of issues
- Ensured company compliance with federal and state laws, including reporting requirements
- Researched employee benefits and provider contracts
- Maintained production and claims quality
Family Caregiver
06.2014 - Current
- Career Transition
Education
Medical office Administration - Health Information/Medical Records Administration/Administrator
New Horizons Computer Learning Centers
04.2016
General Studies - Continuing Education
Tarrant County College
Skills
- Understanding of Medical and Industry terminology
- Strong analytical and technical skills
- Strong oral and written communication skill
- Problem solving skills
- Dependability
- Versatility
Affiliations
Certification
- Certified Medical Administrative Assistant (CMAA), 03/16-01/21
- Certified Biller Coding Specialist (CBCS), 04/16-01/21
- Certified Electronic Health Records (CEHRS), 05/16-01/21
Additional Information
Medical Office Procedures, Insurance Billing & Coding Essentials, Electronic Health Record, Human Anatomy and Physiology, Confidentiality / Discretion, Medical Terminology, ICD-10-Codes
Timeline
Claims examiner
Boon Chapman
06.2020 - 09.2024
Claims Examiner
Silverback TPA
01.2017 - 07.2019
Full-time Student
New Horizons Computer Learning Center
01.2016 - 04.2016
Family Caregiver
06.2014 - Current
Claims Benefit Specialist
Aetna
01.1999 - 06.2014
Medical office Administration - Health Information/Medical Records Administration/Administrator
New Horizons Computer Learning Centers
General Studies - Continuing Education
Tarrant County College
- Certified Medical Administrative Assistant (CMAA), 03/16-01/21
- Certified Biller Coding Specialist (CBCS), 04/16-01/21
- Certified Electronic Health Records (CEHRS), 05/16-01/21
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