CheRee Middleton
Summary
Organized, hardworking , dependable, successful at managing multiple priorities with a positive attitude. Detail oriented with over two years of experience processing/coding claims. Willingness to take on added responsibilities to meet team goals. Currently enrolled in a CPC course through the AAPC and will be completed April 2024.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Claims Processor
Cigna
04.2022 - Current
- Claims processing, checking codes for accuracy
- Identified fraudulent claims through thorough investigation and documentation of findings.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Participated in various professional development opportunities to stay current on industry regulations, best practices, and emerging technologies relevant to claim processing activities.
- Reduced claim processing time for faster customer service and improved satisfaction rates.
- Special Investigations Unit (SIU). Denial of fraudulent claims for services not rendered.
Provider Reimbursement Specialist
Logistics Health Incorporated
07.2021 - 04.2022
- Ensured timely payment of claims by promptly addressing and resolving any discrepancies or issues with insurance providers.
- Contributed to increased team productivity by consistently meeting or exceeding individual processing goals.
- Demonstrated adaptability and a commitment to ongoing professional development, embracing new software systems and process changes with enthusiasm and ease.
- Prevented delays and claim denials by correcting information prior to submission.
- Helped minimize escalations by reaching out to clients in advance of expected problems.
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
Certified Clinical Medical Assistant
Liberty Doctors
03.2021 - 07.2021
- Improved patient flow within the clinic by effectively managing appointment scheduling and timely rooming of patients.
- Assisted physicians in providing quality care through thorough documentation of medical histories and physical examination results.
- Educated patients on preventive healthcare measures such as vaccinations, diet modifications, and exercise routines tailored to their specific needs.
- Prepared patients for examinations or treatments, positioning them properly to ensure comfort throughout the procedure while assisting healthcare professionals as needed.
Certified Clinical Medical Assistant
OrthoSC
11.2018 - 03.2021
- check-in process for patients, verifying insurance information and obtaining necessary paperwork for efficient appointments.
- Improved patient flow within the clinic by effectively managing appointment scheduling and timely rooming of patients.
- Assisted physicians in providing quality care through thorough documentation of medical histories and physical examination results.
- Educated patients on preventive healthcare measures such as vaccinations, diet modifications, and exercise routines tailored to their specific needs.
- Maintained confidentiality of patient information by adhering to HIPAA guidelines at all times during recordkeeping and communications.
- Assisted with routine checks and diagnostic testing by collecting and processing specimens.
- Verified patient insurance coverage and collected required co-payments.
Medical Records Specialist
Careteamplus
07.2019 - 02.2020
- Maintained compliance with HIPAA regulations through thorough staff training and continuous monitoring of security protocols surrounding patient data management.
- Assisted healthcare providers with timely access to patient information, facilitating optimal treatment decisions.
- Reduced errors in documentation by establishing strict quality control measures and conducting regular audits of medical records.
- Provided outstanding customer service to patients requesting copies of their medical records or seeking assistance with related inquiries.
- Addressed discrepancies in medical coding promptly, liaising with relevant parties to rectify errors and maintain accurate billing information.
- Uploaded physician progress notes, history, and physicals into electronic medical records.
- Processed medical records requests from outside providers according to facility, state, and federal law.
- Kept accurate log of requests for medical information and records.
- Reviewed charts and flagged incomplete or inaccurate information.
Education
Bachelor of Arts - Communications
SUNY At Albany
Albany, NY12.2010
Skills
- Medical terminology
- ICD-10 (International Classification of Disease Systems)
- CPT Coding Guideline
- HCPCS Coding Guidelines
- Close attention to detail
- Office support (phones, faxing, filing)
- Excellent verbal communication
- Adept multi-tasked
- Resourceful and reliable worker
- Excellent problem solver
- Office management professional
- Research and data analysis
- Anatomy/Physiology
- Self disciplined
- Microsoft Excel
- Microsoft Word
- Interpersonal Communication Skills
- Self sufficient
- Claims review
- Transactions reconciliation
- Claims
- Claims Processing Software
Affiliations
- American Academy of Professional Coders
- National Healthcare Association
Certification
- AAPC Certified Professional Coder (April 2024)
- Clinically Certified Medical Assistant (NHA 2016)
- Certified Phlebotomy Technician (NHA 2015)
Timeline
Claims Processor
Cigna
04.2022 - Current
Provider Reimbursement Specialist
Logistics Health Incorporated
07.2021 - 04.2022
Certified Clinical Medical Assistant
Liberty Doctors
03.2021 - 07.2021
Medical Records Specialist
Careteamplus
07.2019 - 02.2020
Certified Clinical Medical Assistant
OrthoSC
11.2018 - 03.2021
Bachelor of Arts - Communications
SUNY At Albany