Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Charge Entry and Claims Representative (contract)
Zotec Partners
09.2020 - 09.2023
Review Anesthesia Provider claims, charges, revisions, and rekeys into electronic systems such as EBC
MPI Provider lookups to ensure current credentials
Heavy data entry of demographic information such as insurance and verifications, copays, addresses etc.
Enhanced claim processing efficiency by streamlining workflows and implementing best practices.
Reduced turnaround time for claim settlements by prioritizing tasks and managing deadlines effectively.
Managed approximately 50-100 claims per day from customers.
Benefits Enrollment Specialist
Arkansas Blue Cross Blue Shield
08.2017 - 08.2020
Enter, update, and review data into software systems
Analyze data to identify trends, opportunities, and potential knowledge gaps and seek information
Inbound and Outbound calls related to enrolling in Life with Baby maternity program and eligibility for free breast pumps as well as assignment for personal RN nurse to provide care to the member throughout her pregnancy.
Resolved issues and inquiries from plan participants regarding health and welfare benefits and deductions through telephone, email interactions.
Implemented open enrollment system to streamline benefits processes for employees.
Patient Care Coordinator (contract)
Cardinal Health Inc.
09.2016 - 03.2017
Direct drug distribution to site-of-care with non-commercial pharmacy services, patient access support, and financial programs, working with the organization Sonexus Health, a subsidiary of Cardinal Health, helping specialty pharmaceutical manufacturers have a greater connection to the customer experience and better control of product success
Enhanced customer satisfaction by promptly addressing inquiries and resolving issues efficiently.
Referrals such as for home health, physical therapy, smoking cessation, dermatology, rheumatology, to name a few
Duties such as but not limited to, contacting review organizations and insurance companies to ensure prior approval requirements are met
Present necessary medical information such as history, diagnosis and prognosis
Provide specific medical information to financial services to maximize reimbursement to the hospital and physicians
Ensuring that referrals are addressed in a timely manner and reminding patients of scheduled appointments via mail or phone
Providing personalized services such as assisting patients with their Hardship Assistant Program Enrollment Applications and also providing resources for more help such as Low Income Subsidy help in paying expenses for medication.
Patient Care Volunteer for ICU/NICU
University of Medical Sciences
02.2010 - 02.2017
Enhanced patient comfort by providing compassionate care and supportive communication.
Supported the nursing staff in delivering timely and efficient care through assistance with routine tasks and procedures.
Improved patient satisfaction by assisting with daily living activities, such as bathing, dressing, and feeding of critically ill patients.
Provided emotional support for patients and their families during difficult times in illness or recovery processes.
Maintained a safe environment for patients by adhering to infection control protocols and reporting hazards promptly.
Certified Registered Medical Assistant (contract)
Walker Internal Medicine Clinic Baptist Medical Center
06.2016 - 08.2016
Perform administrative and certain clinical duties under the direction of physician
Clinical duties to include recording vital signs, medical histories, preparing pap smears, blood draws, glucose monitoring, A1c testings and urinalysis as directed by a physician.
Streamlined office operations for improved patient experiences through effective communication with healthcare providers.
Ensured accurate billing processes through diligent verification of insurance coverage and prompt submission of claims forms to insurers or government agencies as required.
Safeguarded patient privacy rights by consistently following HIPAA regulations in all tasks involving personal health information management or data exchange between parties involved in their care process.
Directed patients to exam rooms, fielded questions, and prepared for physician examinations.
Certified Registered Medical Assistant (contract)
St. Vincent Primary Care Clinic
03.2015 - 05.2016
Perform administrative and certain clinical duties under the direction of physician, Administrative duties include scheduling appointments, and surgeries, prior authorizations, maintaining medical records, ICD 10 and CPT billing and coding for insurance purposes
Referrals such as for home health, physical therapy, smoking cessation, dermatology, rheumatology, to name a few
Duties such as but not limited to, contacting review organizations and insurance companies to ensure prior approval requirements are met
Present necessary medical information such as history, diagnosis and prognosis
Provide specific medical information to financial services to maximize reimbursement to the hospital and physician
Clinical duties may include taking and recording vital signs and medical histories and inputting into various EMR systems, verifying insurance, taking copays, performing ECG/EKG, Stress Testing, Holter Monitoring, X-Ray's, preparing patients for examinations, blood draws, UA's, eye exams, processing lab orders, assisting with pap smears, assisting with skin biopsies and other minor surgeries, and administering medications and injections as directed by physician.
Certified Registered Medical Assistant
Little Rock Diagnostic Clinic
07.2014 - 01.2015
Perform administrative and certain clinical duties under the direction of physician
Administrative duties may include weight loss consultations, scheduling appointments, maintaining medical records, billing, and coding for insurance purposes
Clinical duties may include taking and recording vital signs and medical histories, preparing patients for examination, drawing blood, and administering medications and injections as directed by physician.
Medical Assistant Student Intern
Center For Arthritis And Rheumatic Diseases
04.2014 - 06.2014
Completed 200 hours of clinical and administrative duties for the Medical Assisting Program at Everest College
Administered injections, checked vital signs, and input patient data into electronic medical records
Updated patient charts and helped about 20 patients per day
Conduct various clerical duties such as maintained medical files, answered phones, used office machines, and data entry
Assisted patients with IV pump setup and removal, blood draws, fluid extractions of the joints.
Education
Technical Degree - Medical Assisting
Everest College
Chesapeake, VA
07.2014
High School Diploma -
Camden Fairview High
05.2010
Skills
Time Management
Team Collaboration
Flexible Schedule
Claims Investigation
Insurance Claims Review
Microsoft Office
Data Entry
Documentation Review
Customer Service
Eligibility Determination
Claim Amount Calculations
Interpersonal Skills
Certification
Certified Clinical Medical Assistant (CCMA)
Nationally Registered Certified Medical Assistant (NRCMA)
Certificate for completion of Medical Professions; Southern Arkansas University Tech – May 2010
Timeline
Charge Entry and Claims Representative (contract)
Zotec Partners
09.2020 - 09.2023
Benefits Enrollment Specialist
Arkansas Blue Cross Blue Shield
08.2017 - 08.2020
Patient Care Coordinator (contract)
Cardinal Health Inc.
09.2016 - 03.2017
Certified Registered Medical Assistant (contract)
Walker Internal Medicine Clinic Baptist Medical Center