Bobbi Norman
Jacksonville,FL
Overview
5
5
years of professional experience
Work History
CNA - Certified Nursing Assistant
Baptist Medical Center - Jacksonville, FL
- Current
- The Certified Nursing Assistant will be responsible for assisting the Registered Nurse (RN) with the care of patients who have healthcare needs including: Activities of Daily Living; Maintaining a safe environment; Collecting lab specimens; Intake and output monitoring; Tend to the patients needs Charting ( EPIC )Patient Service Representative
Claims Benefit Specialist
Aetna, a CVS Health Company
02.2022 - Current
- Applies medical necessity guidelines, determine coverage, complete eligibility verification, identify discrepancies, and applies all cost containment measures to assist in the claim adjudication process
- Proofs claim or referral submission to determine, review, or apply appropriate guidelines, coding, member identification processes, provider selection processes, claim coding, including procedure, diagnosis and pre-coding requirements
- In accordance with prescribed operational guidelines, route/queues, and ECHS within specified turn-around-time parameters (Electronic Correspondence Handling System-system used to process correspondence that is scanned in the system by a vendor)
- Utilizes all applicable system functions available ensuring accurate and timely claim processing service (i.e., utilizes Claim Check, reasonable and customary data, and other post-containment tools)
- Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management
- Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible.
Patient Service Representative
Bristol Myers Squibb / Lash group - Jacksonville, FL
11.2020 - 03.2021
- Patient Care, Order Entry, Handle complaints as respectfully and diligently as possible, Made sure the patient hang up the phone with a better attitude from when they came on the phone, Great at Excel, Outlook, Word, Skype
Claims Representative
Lash Group
11.2020 - 03.2021
- Suspends claims requiring additional information and/or special handling; initiates action to obtain required information
- Forwards claims requiring external department intervention to the appropriate department or person
- Monitors outstanding inquiries and works with management staff to identify and resolve areas of noncompliance
- Reviews and verifies quality audit reports
- Reconciles audit discrepancies, corrects in system and make appropriate changes to avoid recurrence
- Maintains thorough knowledge of claims process systems, its databases and subsystems
- Responds to and resolves provider and health plan claim inquiries.Monitors and tracks aged, pended, and open reports to maintain timeliness in claims processing.Inputs claims into the system for appropriate tracking and processing
- Documents file, as appropriate, to support payment decision
- Serves as a Subject Matter Expert and conducts training as required
- Conducts cross training to staff as required
- Actively participates in user acceptance testing functions, such as test script development, testing and documentation of test results.
Patient Scheduler
PopHealthCare LLC - Jacksonville, FL
03.2020 - 10.2020
- Assist with inbound inquires and request, Documenting and updating member, Work in multiple platforms ( Five9, Outlook,Sharepoint, Teams, EMR ), Conducting outbound calls for insight, Customer service skill and sales, Encourage member to enroll in home - health screening., Scheduling
FULL SPECIALIST
Parisian Spa Institute - Jacksonville, FL
07.2019 - 11.2019
- Developed and maintained quality relationships with clients through follow-up practices
- Exceeded sales goals and expectations on various skin care brands by using up-selling
- Upholding the standards of sanitation and sterilization as directed by law and the spas polices and procedures
- Attended training and education courses to train peers in various skin care brands
- Strong verbal, written
- Interpersonal skills
Timeline
Claims Benefit Specialist
Aetna, a CVS Health Company
02.2022 - Current
Patient Service Representative
Bristol Myers Squibb / Lash group - Jacksonville, FL
11.2020 - 03.2021
Claims Representative
Lash Group
11.2020 - 03.2021
Patient Scheduler
PopHealthCare LLC - Jacksonville, FL
03.2020 - 10.2020
FULL SPECIALIST
Parisian Spa Institute - Jacksonville, FL
07.2019 - 11.2019
CNA - Certified Nursing Assistant
Baptist Medical Center - Jacksonville, FL
- Current
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