Cheryll Easy-James
Ocala,FL
Summary
Healthcare representative with 8 years of dependable experience with Medicare, denials, billing and collections, insurance verification and medical terminology. Highly analytical person that will strengthen an organization's denial, billing, follow up, or management department. Looking to foster and build productive relationships and communicate to establish credibility, trust, and improve productivity within an organization. Tenacious Representative possessing dynamic interpersonal expertise for developing fruitful customer relationships. Adept mediator of client requirements and organizational interests promoting mutually beneficial deals. Focused communicator fostering favorable service applications for maximizing customer interest and satisfaction.
Overview
15
15
years of professional experience
Work History
Denial Representative, Follow up Representative
Conifer Healthcare Solutions
05.2015 - Current
- Manages Medicare denials by conducting comprehensive review of clinical documentation
- Write compelling dispute letters based on clinical documentation
- Research Payer denials related to referral, medical necessity, pre-authorization
- Initiate appeals with insurers timely and appropriately
- Submit detailed appeals to payers based on medical records
- Performed billing functions which included submitting claim electronically, reconciling, and balancing accounts, reviewed patient EOB; maintained facility aging below 15%
- Manage desk inventory
- Responsible for A/R inventory
- Identify Trends in Medicare rejections or denials
- Developed and maintained positive customer relations and coordinated with team members to properly handle requests and questions.
- Responded to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.
- Monitored service capabilities and collaborated cross-functionally to meet needs and resolve escalated issues.
- Exceeded established sales goals and increased client retention.
- Excellent communication skills, both verbal and written
- Applied effective time management techniques to meet tight deadlines
- Demonstrated respect, friendliness and willingness to help wherever needed
- Exercised leadership capabilities by successfully motivating and inspiring others
- Participated in team projects, demonstrating ability to work collaboratively and effectively
Customer Service Representative
Jet Blue Airways
04.2008 - 07.2013
- Satisfied customer service excellence by managing workflow for flight operations, produce daily general declaration forms daily for international flights
- Assist customers with check in
- Fax & file documents; transfer calls to appropriate departments
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Responded to customer requests for products, services, and company information
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
- Offered advice and assistance to customers, paying attention to special needs or wants
Education
Bachelor of Arts - Health Administration
Ashford University
San Diego, CA09.2018
Associate of Arts - Health Administration and Medical Records
University of Phoenix
Tempe, AZ01.2012
Skills
- Account Management & Reconciliation Electronic
- Medical Records Management Billing & Collections
- Insurance Verification & Pre authorization HIPPA
- Electronic Patient Medical Record
- Premium Calculations
- Identifying Errors
- Medicare Compliance
- Regulatory Compliance Project Management
- Medical Terminology Medicare DDE EPREMIS Kronos
- Star Cerner Common Working File MS Word Excel
- Power point Outlook ICD 9 & 10 Customer Service
- Superior attention to detail
- Follow-up skills
Timeline
Denial Representative, Follow up Representative
Conifer Healthcare Solutions
05.2015 - Current
Customer Service Representative
Jet Blue Airways
04.2008 - 07.2013
Bachelor of Arts - Health Administration
Ashford University
Associate of Arts - Health Administration and Medical Records
University of Phoenix
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