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
Columbia, SC, United States
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
Columbia, SC, United States
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
Columbia, SC, United States
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
Columbia, SC, United States
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
Lexington, SC, United States
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
United States
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
Columbia, SC, United States
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