Christina L Sesti
Freeburg,Missouri
Summary
Talented Coordinator proven successful in leading team members in high-volume clinic settings. Knowledgeable about medical regulations, managing files and producing professional correspondence for diverse needs. Articulate communicator with strong attention to detail and superior work ethic.
Experienced in Missouri Medicaid reimbursement billing.
Professional and well-grounded office team member with superior clerical skills and medical expertise. Successful at satisfying customer needs while meeting and exceeding business objectives. Smoothly handles all types of administrative tasks, including coordinating mail, records, appointment scheduling and travel arrangements.
Overview
29
29
years of professional experience
Work History
Program Coordinator
Centene
Milwaukee, WI
10.2022 - Current
- Conducted research and planning necessary to assist with program evaluation, assessment, and annual reports.
- Maintained quality assurance procedure documentation.
- Identified quality problems and recommended solutions.
- Analyzed issues and recommended corrective actions to improve final results.
- Contributed to business growth by confirming customer satisfaction with service and quality.
- Participated in calibration sessions with upper management to promote consistent alignment on policies and processes.
- Maintained policy, procedures, work instructions and projects for quality and continuous improvement agendas.
- Leveraged Lean Six Sigma principles to identify and communicate compliance risks and quality improvement opportunities.
- Documented meetings with details in regards to team preferences, financial considerations and successes and failures.
Office Assistant
SSM Health Care
Jefferson City, MO
09.2016 - Current
- Managed reception and lobby area, greeted visitors and responded to requests for information.
- Received and screened high volume of internal and external communications.
- Updated financial, customer and business records with accurate information each day, preventing data loss and keeping files current.
- Filed and retrieved records to support business needs and boost team productivity.
- Scheduled appointments on behalf of staff members to keep office operations smooth and efficient.
- Tracked office stock and maintained inventory in neat and organized fashion.
- Served as central point of contact for all outside vendors needing to gain access to building.
- Processed paperwork efficiently to support smooth office procedures.
- Supported clerical needs of more than 9 doctors and nurse practitioners , including taking messages, scanning documents and routing business correspondence.
- Dispersed incoming mail to correct recipients throughout office.
- Maintained office supplies inventory by checking stock and ordering new supplies as needed.
- Assisted with administrative tasks, including filing, answering phones and fax distribution.
Lead Billing Coordinator
Rehab Specialty Medical
Jefferson City, MO
05.2014 - 08.2016
- Responsible for filing and tracking all insurance claims for various insurances for 800+ patients monthly.
- Insurance experience includes Anthem BCBS, Coventry, Care Improvement Plus, Tricare, Medicare, Medicaid\CIMOR, UMR, Healthlink, Healthscope, Coresource, UHC and Cigna.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Input details into accounts and tracked payments.
- Prepare durable medical insurance claim forms or appeals in a timely manner.
- Maintain patient eligibility files and update as needed.
- Responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process.
- Respond to new phone inquiries collecting appropriate data, and any other phones inquires for patients, care coordinators and physician offices.
Provider Communications Specialist
Wipro/ Infocrossing
Jefferson City, MO
06.2008 - 05.2014
- Medicaid inbound call center.
- Demonstrated analytical and problem-solving ability by addressing claims for accuracy and completeness.
- Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
- Educated clients on proper billing guidelines.
Reimbursement Specialist/Medical Coder
GroupOne Healthsource
Jefferson City, MO
05.2005 - 06.2008
- Verify appropriate patient insurance eligibility, bill claims on appropriate claim forms, follow up on claims to ensure prompt payment, and file appeal claims as necessary.
- Process payments and refunds as needed.
- Maintained confidentiality and integrity of patient data.
- Researched rejections, investigating problems to appeal claims.
- Coded patient care records to provide accurate information for billing.
- Educated physicians, staff, patients and stakeholders on service documentation for procedures and coding requirements.
Claims Processor
InfocrossingWipro
Jefferson City, MO
05.2005 - 06.2005
- Approve, and process Medicaid claims for the state of Missouri.
- Verified claim data accuracy in preparation for processing.
Consumer Solutions Representative
Sprint
Jefferson City, MO
08.2004 - 05.2005
- Handle all customer needs in an inbound call center environment.
- Solve various billing issues.
- Transitions to sales of add on products.
- Identified consumer needs, clarified information and researched issues to provide alternative solutions.
- Resolved complex customer issues by identifying source of customer's issue providing resolution.
Inside Sales Representative
SestiCingular Wireless/Southwestern Bell Wireless
St. Louis, MO
09.1995 - 08.2004
- Responsible for the sales and training of cellular equipment and various billing issues.
- Meeting and exceeding sales objective on a monthly basis, on average 110% over objective consistently over a period of 24 months.
- Top sales rep in JC store March 99, August 99, October 99, January 00, May 00, July 00, and August 00.
- Transfer from Jefferson City).
- Negotiated prices, terms of sale and service agreement to close transactions.
Education
Some College (No Degree) - Business Communications
Patricia Stevens College
St Louis, MOSome College (No Degree) - Medical Insurance Coding
Lincoln University
Jefferson City, MOSkills
- Customer Service
- Information Confidentiality
- Verbal and Written Communication
- Mail Sorting and Distribution
- Data Entry
- Clerical Support
- Excel Spreadsheets
- Appointment Scheduling
- Microsoft Office
- Self-Motivated
- Multitasking and Prioritization
- Reliable and Punctual
- Flexible and Adaptable
- Problem Solving
- Attention to Detail
- Interdepartmental Coordination
- Time Management
- Decision Making
- Performance Quality Assurance
Affiliations
- Youth Soccer coach
Accomplishments
- Documentation - Wrote and edited documents to keep staff informed on policies and procedures.
Timeline
Program Coordinator
Centene
10.2022 - Current
Office Assistant
SSM Health Care
09.2016 - Current
Lead Billing Coordinator
Rehab Specialty Medical
05.2014 - 08.2016
Provider Communications Specialist
Wipro/ Infocrossing
06.2008 - 05.2014
Reimbursement Specialist/Medical Coder
GroupOne Healthsource
05.2005 - 06.2008
Claims Processor
InfocrossingWipro
05.2005 - 06.2005
Consumer Solutions Representative
Sprint
08.2004 - 05.2005
Inside Sales Representative
SestiCingular Wireless/Southwestern Bell Wireless
09.1995 - 08.2004
Some College (No Degree) - Business Communications
Patricia Stevens College
Some College (No Degree) - Medical Insurance Coding
Lincoln University
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