Dejahnee McFadden
Cayce,SC
Summary
Motivated professional seeking a lucrative position to acquire and develop new skills. Committed to continuous learning and growth, dedicated to contributing expertise to a dynamic work environment. Driven for success, aiming to make a significant impact and thrive in a challenging and inspiring role.
Overview
15
15
years of professional experience
Work History
Patient Accounting Associate II, Analyst
TRC Staffing
01.2023 - Current
- Confirmed payment statuses for claims and revised account information.
- Executed strategies to achieve full payment resolution on insurance claims.
- Leveraged appeal processes to recover outstanding claim payments.
- Collected essential demographic, clinic details, and medical records crucial for settling outstanding claims.
- Worked effectively on complex claims related to Medicare, VA, Tricare, and Managed Care and Commercial
- Identify adjustments to be processed on accounts
- Delivered training assistance to new hires in Patient Accounting Department.
- Adhere to HIPAA regulations when handling sensitive healthcare information
- Collaborate with other departments to ensure proper coding of services rendered by the facility
- Provided individual feedback to leadership
- Managed and organized reports efficiently with Excel.
- Identify and report trends for claim denials
- View patient accounts using EPIC and Meditech
- Created and managed pivot tables to analyze patient accounting data.
- Identified trends in patient accounting data and consulted with clients to develop effective resolutions.
- Facilitated targeted training sessions to support employees struggling with patient accounting processes.
- Facilitated employee one-on-one meetings alongside team lead to enhance team communication and performance.
- Performed quality audits to ensure compliance with organizational standards and provided actionable feedback to enhance performance.
- Contributed to successful completion of special projects as assigned by senior management or partners in the firm.
- Maintained up-to-date knowledge of accounting regulations, industry standards, and best practices through continuous professional development activities.
- Mentored junior team members, sharing knowledge and expertise to promote professional growth within the department.
- Managed multiple simultaneous projects, ensuring timely completion and accurate results in a fast-paced environment.
- Collaborated on collection and dispute resolution issues.
- Identified and discussed with management opportunities for improvements to procedures and internal controls.
- Monitored accounts receivable aging and worked with various areas to address business needs.
- Prepared accounts receivable-related journal entries for accounting month-end close.
- Provided training for new hires on best practices in collections strategies, contributing to a well-prepared team.
- Reviewed and processed entry adjustment requests, enhancing accuracy in patient account resolutions.
Patient Accounting Associate II
Recruiting Solutions VBO/PWC
05.2021 - 01.2023
- Verify claim payment status, rebill claim to patient's insurance, proration to correct financial class and notate patient accounts with steps taken to resolution
- Ability to understand/interpret reason for insurance payment or insurance payment denial and work account to payment resolution
- Resolved issues with claim denials using established appeal procedures.
- Compiled demographic, clinical data, medical records, authorizations and insurance details essential for claim resolution.
- Navigated reimbursement procedures across diverse Government-sponsored insurance programs like Medicare Advantage and Medicaid Advantage.
- Identify adjustments to be processed on accounts
- Establish where balance is coming from on patient accounts
- Contacted payers to obtain clarification on claim denials related to HCPCS/CPT codes.
- Verify authorizations via HIS/EPIC
- Research medical records via HIS
- Accessed patient account details using Athena IDX and RMS/CENTRICITY applications.
- Access claim/eligibility information through various payer portals
- Resolve claim issues
- Consistently achieved daily productivity targets.
- Maintained adherence to quality standards.
- Elevated to PAII following a half-year tenure.
- Read and understand UBO4 claim form
- Read and understand 1500 claim form
- Understand difference between facility and professional claims
- Promoted to Top to bottom after 60 days in production
- Submit claims via Nthrive and acclaims
- Post adjustments to account balances
- Submit appeals
- Submit medical records
- Audit quality and processing of representative accounts
- Delivered hands-on support to familiarize new hires with workplace processes.
- Secure approval for retrospective requests.
Teacher Assistant
Shandon Weekday School
05.2018 - 08.2020
- Designed and executed tailored lessons for children aged 4 to 5.
- Create monthly lesson plans adhering to SC learning standards
- Ensure the safety of up to 18 children based on DSS guidelines
- Create an open friendly atmosphere in which children and parents feel comfortable
- Provide experiences that promote individual expression through conversation, play and creativity
Teacher Assistant
Incarnation Church
12.2017 - 05.2018
- Plan and conduct an effective child development program to meet the physical, social, emotional and intellectual needs of each child
- This should be done based on the goals and general curriculum plan of Incarnation
- Ensure that child care routines are carried out in a manner that is prompt, hygienic, and consistent with the good child development principles
- This includes routines related to diapering, hand washing, eating, napping and transitioning between activities
- Ensure the safety of children through constant supervision, effective arrangement of space, proper maintenance of equipment, and regular practice of fire drills and other emergency procedures
- Operate the classroom in compliance with all child care licensing standards, and Employee and Policy Handbooks
- Create an open, friendly, and cooperative atmosphere in which children and families feel comfortable and secure
- Provide experiences that promote individual expression through conversation, play and creativity
- Provide a variety of language stimulation activities
- Ensure that parents receive adequate information about their child's experiences at the center through daily contacts and regularly scheduled parent conferences
Medical Billing Specialist
Medical Services of America
12.2015 - 06.2016
- Accurately process medical claims for durable medical equipment
- Manually correct procedure codes from ICD9 to ICD10 codes
- Create and submit Medical Necessity forms and prior authorizations
- Meet and exceed required claims processing and payment goals
- Resolve claims issues and resubmit with corrections
Customer Service Advocate II
Blue Cross Blue Shield
12.2014 - 10.2015
- Process medical claims and verify accuracy
- Maintain knowledge of the Affordable Care Act
- Process non routine request for members
- Provide solutions to telephone inquiries
- Explains insurance benefits and claims processes to members
Administrative Specialist II
DHEC/WIC
02.2010 - 01.2012
- Maintained professionalism, through attire and attitude
- Verified Medicaid or health insurance through CARES database
- Accommodated clients of all cultures, races, and nationalities with use of an interpreter if necessary
- Verified each client's information for client certification and all needed proof for certification
- Maintained medical records by entering client information into CARES database
- Issued WIC vouchers and accounts for each receipt through an organized filing system
- Independently prepared non routine letters and reports
- Sufficiently trained new employees
- Solely operated off site clinics, on Fort Jackson, Eastover and Eau Claire when needed
- Handled and resolved complaints to accommodate client in the best way possible
- Mufti-tasked by operating front desk, telephone and schedule
Education
Bachelors - Business Administration with Healthcare Admin
Colorado Technical University
12.2025
High school -
Lower Richland High school
01.2006
Skills
- PowerPoint
- ICD-9
- ICD-10
- Records Management
- Time Management
- Phone Etiquette
- Data Entry
- Administrative experience
- Microsoft Outlook
- Medical Coding
- Epic
- Medical Billing
- Medical Records
- Written communication
- Protecting patient privacy
- Speaking clearly, correctly, and concisely
- Meditech
- Understanding the procedures and forms used for medical billing
- Data Entry (45 WPM)
- Computer Skills
- Word
- Excel
- Access
- Windows Vista/XP
- Microsoft Office
- Past Due Balance Management
- Software Applications
- Cash flow management
- Data entry
- Month-end closing
- Microsoft office
- Attention to detail
- Proactive and Self-motivated
- Critical thinking
- Accounts receivable
Awards And Acknowledgements
- Featured as employee of the month in Newsletter
- Certified Cardiac Care Technician
- Created a job aid for billing claims via Nthrive
- Selected for training sessions for new hires
- Several productivity awards received
Timeline
Patient Accounting Associate II, Analyst
TRC Staffing
01.2023 - Current
Patient Accounting Associate II
Recruiting Solutions VBO/PWC
05.2021 - 01.2023
Teacher Assistant
Shandon Weekday School
05.2018 - 08.2020
Teacher Assistant
Incarnation Church
12.2017 - 05.2018
Medical Billing Specialist
Medical Services of America
12.2015 - 06.2016
Customer Service Advocate II
Blue Cross Blue Shield
12.2014 - 10.2015
Administrative Specialist II
DHEC/WIC
02.2010 - 01.2012
Bachelors - Business Administration with Healthcare Admin
Colorado Technical University
High school -
Lower Richland High school
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