Chasidy Rhodes

Review and correct claims rejected by the payer.

Reviewed and resolved payer claim rejections, including claim resubmission and updating payer identification for accounts.

Documented root causes of payer rejections for trend analysis and staff training.

· Requesting process and/or system edit modifications to eliminate or reduce future payer claim rejections.

Tracked payer rejections and delivered reports to Billing Manager for distribution to impacted departments.

Identify and recover improper Medicaid payments, focusing on areas like incorrect coding, duplicate services, and fraud.
Perform both automated and complex reviews of claims, potentially requesting medical records for further analysis.
Conduct detailed reviews of selected claims, including medical record reviews, to ensure that services billed were medically
necessary and appropriately documented.

Resolve credit balances on patient accounts; Research returned hospital
refund checks.
Initiate refunds or identify overpayments to clear credit balance.

Apply voids to accounts as necessary and reissue refund. Document collection
system clearly and concisely.

Identify and recover improper Medicaid payments, focusing on areas like incorrect coding, duplicate services, and fraud.
Perform both automated and complex reviews of claims, potentially requesting medical records for further analysis.
Conduct detailed reviews of selected claims, including medical record reviews, to ensure that services billed were medically
necessary and appropriately documented.

Contracted by Prime Therapeutics to process prior authorizations.
Started case files for formulary exceptions & prior authorizations.
Monitored physician review, additional information queues and attached
them to original case files. Used ICD-9 codes to determine the patient's
diagnosis.Increased customer satisfaction by ensuring timely completion of projects and adherence to high-quality standards.
Trained new employees on multiple programs and data entry software.
Enhanced overall team performance by providing regular coaching,
feedback, and skill development opportunities.
Promoted a positive work environment by fostering teamwork, open
communication, and employee recognition initiatives.

Contracted by Homeland Security
Provided administrative support to business operations by performing
data entry of material from temporary work visa documents to a
computer database.
Transcribed routine pre-coded alphanumeric data from source
documentation into an automated system.
Ensured accuracy and completeness of data. Performed clerical tasks in
the data entry function.