Chandra Byrd
Irving,TX
Overview
14
14
years of professional experience
1
1
Certification
Summary
Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims.
Work History
Claims Representative
United Healthcare Group
Irving, Texas
09.2018 - Current
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Paid or denied medical claims based upon established claims processing criteria.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Monitored and updated claims status in claims processing system.
- Processed 200-300 claims daily
- Maintained strong knowledge of basic medical terminology to better understand services and procedures
Claims Examiner
HealthSmart Inc
Irving, Texas
09.2021 - 07.2023
- Processing medical claims by approving or denying documentation or composing denial letter
- Following-up on pended claims in timely fashion and as needed
- Maintaining and utilizing resource materials necessary to perform job responsibilities effectively.
- Follows company policies, procedures, guidelines, as well as state and ensure legal compliance
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Paid or denied medical claims based upon established claims processing criteria.
- Processed 200- 300 claims daily
Benefits Customer Service Representative
HealthSmart Inc
Irving, Texas
09.2018 - 10.2021
- Notating patient accounts regarding account activity
- Verify patient benefits, copays and eligibility information for providers
- Review patient claims statuses and/or explain reasons for denials
- Documented customer interactions and transactions for accurate, up-to-date records.
- Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers
- Working knowledge of Protected Health Information (PHI), HIPPA
Document Custody Supervisor-Fannie Mae
Nationwide Title Clearing
Dallas, Texas
04.2017 - 04.2018
- Assigned mortgage loans and other documents to team members to be filed
- Reporting daily/weekly production file activity of team members, verifying accurate file location of loan and trailing documents
- Trained newly hired team members, hosted daily team hurdles
- Accessed and toggled between internal systems while ensuring client information was protected and secured
- Supervised 20-24 employees daily.
- Evaluated employee performance and coached and trained to improve weak areas.
- Enforced rules and regulations outlined in company manual to set forth expectations comprehensibly and consistently.
Medical Billing and Coding Specialist
ATMB Services Inc
Houston, TX
01.2016 - 04.2016
- Reviewed patient medical bill records for errors
- Assigned CPT, HCPCS, and ICD-10 codes to diagnoses, and procedures
- Submitted patient medical claims for payment
- Updated patient account ledger using Medisoft clinical program software
- Placed calls to insurance providers to verify status, or reasons for denials of claims.
- Followed all company policies and procedures to deliver quality work.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
Hemodialysis Technician
Metropolitan Kidney Centers Inc.
Chalmette, LA
02.2014 - 12.2014
- Monitored patients and equipment, responded to alarms, readjusted treatment parameters as defined by established protocols, and individual patient requirements
- Obtained and recorded vital signs, temperature, and weight
- Prepped and sanitized patient access sites prior to cannulation
- Maintained professional conduct, good communication skills, and patient confidentiality.
- Completed dialysis machine and equipment setup prior to patient treatment and performed safety tests to verify readiness.
- Followed prescribed infection control protocols and wore personal protective equipment to minimize contamination risk.
- Reinforced patient and caregiver education to enhance understanding of disease and prescribed treatment protocols.
Hemodialysis Technician
Dialysis Centers Inc
New Orleans, LA
10.2013 - 01.2014
- Maintained professional conduct, good communication skills, and patient confidentiality, while learning hands-on from licensed RN, and certified dialysis technician/preceptors.
Operations Fraud Specialist
Citigroup Financial
Irving, TX
10.2010 - 08.2012
- Utilized judgmental decisions to prevent, detect, investigate external, and internal fraud activity.
- Reviewed, processed, or denied consumer applications for credit
- Placed security hold on account, due to possible fraud activity until verified, or denied by account holder, or victim
- Notated consumer accounts regarding account activity, or concerns by account holders for future references when needed by next customer service representatives.
- Reviewed reports and individual transactions which appeared suspicious to uncover possible fraudulent activity.
- Evaluated customer data to identify and prevent fraudulent activities.
- Contacted customers directly to notify of fraudulent activity and minimize impacts.
Medical Assisting/Phlebotomist Training
Bureau of Prisons Federal Medical Center
Fort Worth, TX
07.2010 - 08.2010
- Cleaned and sterilized instruments and disposed of contaminated supplies.
- Changed, and cleaned patient wounds and dressings; Prepared, and administered medications as directed by physician.
- Obtained patients vital signs, weight, and height.
- Conducted venipuncture and other CT procedures.
- Assembled tourniquets, needles, and blood collection devices to prepare work trays.
- Tracked collected specimens by initialing, dating, and noting times of collection.
- Monitored patients for reactions and verified sample quality.
- Reviewed patient records for accuracy and completeness.
- Used personal protective equipment correctly to protect coworkers and patients.
- Completed proper sanitation and cleaning of equipment and work areas between patients.
Education
Degree: Associates of Occupational Studies - HIM- Medical Billing & Coding
Blue Cliff College - Alexandria
Alexandria, LA01.2016
Degree: Diploma - Dialysis Technology
Blue Cliff College
Cleary, Metairie, La.2013
Diploma - Medical Assisting
ATI Career Training Center - North Richland Hills
North Richland Hills, TX2010
High School Diploma -
Lawrence D. Bell High School
Hurst, United States05.2000
Skills
- Decision-Making
- Policy Understanding
- Insurance Verification
- Healthcare Regulations
- Claims Processing
- Medical Billing
- HIPAA Compliance
- Microsoft Office
- Medical Terms and Procedure Knowledge
- Customer Service
- Medical Record Review
- Telephone Etiquette
- Critical Decision-Making
- Medical Software
Certification
- CMA - Certified Medical Assistant
- CPT - Certified Phlebotomy Technician
- Commissioned Notary Public- 08/29/2022- 08/29/2026
Timeline
Claims Examiner
HealthSmart Inc
09.2021 - 07.2023
Benefits Customer Service Representative
HealthSmart Inc
09.2018 - 10.2021
Claims Representative
United Healthcare Group
09.2018 - Current
Document Custody Supervisor-Fannie Mae
Nationwide Title Clearing
04.2017 - 04.2018
Medical Billing and Coding Specialist
ATMB Services Inc
01.2016 - 04.2016
Hemodialysis Technician
Metropolitan Kidney Centers Inc.
02.2014 - 12.2014
Hemodialysis Technician
Dialysis Centers Inc
10.2013 - 01.2014
Operations Fraud Specialist
Citigroup Financial
10.2010 - 08.2012
Medical Assisting/Phlebotomist Training
Bureau of Prisons Federal Medical Center
07.2010 - 08.2010
Degree: Associates of Occupational Studies - HIM- Medical Billing & Coding
Blue Cliff College - Alexandria
Degree: Diploma - Dialysis Technology
Blue Cliff College
Diploma - Medical Assisting
ATI Career Training Center - North Richland Hills
High School Diploma -
Lawrence D. Bell High School
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