Darryl Blackshear

• Analyzing Claims submitted by Dr. Offices and Hospitals
• Auditing Appeals from providers
• Conduct thorough investigations in order to determine a decision for appeals based on the procedures or guidelines required by Medicare
• Send out denial letters that did not meet requirements
• Reviewing emails using Microsoft Outlook
• Completed in-depth investigations into issues pertaining to discipline and grievance management and recommended strategies.
• Completed documentation of final appeals or grievance determination using appropriate templates.

Process Account Receivables and Accounts Payables Daily

• Audit high dollar amount numbers daily to ensure proper payment is made to the provider
• Withhold funds the provider may owe Medicare due to overpayment
• Assist providers with denied Medicare claims
• Adjust incorrect processed claims
• Provide Medicare eligibility benefits for patients and educate providers on how to accurately submit Medicare claims

• Understanding foreclosure, property preservation, and bankruptcy verbiage and processes
• Reviewing and analyzing invoices based on client's rules and guidelines
• Approved, adjusted or denied high dollar amount Invoices based on accuracy and efficiency.
• Review information and documents from client systems and process management system
• Worked independently within a team environment
• Using logic and reasoning to identify the strengths and weaknesses of alternative solutions to issues