Dontavus Moultrie

⦁ Review and analyze denied or underpaid medical claims to determine the reason for rejection and assess the appropriate course of action.
⦁ Prepare and submit appeals to insurance providers by gathering necessary documentation, medical records, and supporting evidence to justify claims.
⦁ Communicate with healthcare providers, insurance companies, and patients to resolve claim issues and ensure timely reimbursement.
⦁ Interpret insurance policies, benefits, and guidelines to ensure claims are processed in compliance with regulations.
⦁ Track and monitor appeal outcomes, ensuring that deadlines are met and claim statuses are updated in the system.
⦁ Maintain detailed records of claims, appeals, and outcomes to provide accurate reporting and follow-up.
⦁ Collaborate with internal teams, including billing, coding, and medical staff, to gather pertinent information for successful appeals.
⦁ Stay current on industry regulations, payer policies, and coding guidelines to optimize claims processing and resolution

⦁ Assessed clients' needs and determined eligibility for intake services.
⦁ Answered phone calls and provided new clients with required paperwork to initiate service.
⦁ Maintained accurate, up-to-date client records for reliable reference and communications.
⦁ Completed intake assessment forms and filed clients' charts.
⦁ Streamlined intake systems, resulting in reduced errors and improved speed.
⦁ Provided support to social service clients in navigating available resources

⦁ Implemented change control, configuration status accounting and configuration audits.
• Supported customers and government teams with accurate, timely information on infrastructure system and service configuration items.
• Troubleshot incidents reported by end-users to schedule system changes and identify permanent solutions.
• Communicated and explained business requirements to team members to understand and implement functional demands.
• Analyzed existing systems and databases and recommended enhancements to solve business needs
⦁ Entered and maintained departmental records in company database.

• Assisted management with developing and managing employee improvement strategies to encourage exceptional performance from staff.
• Monitored cash drawers in multiple checkout stations to confirm adequate cash supply.
• Helped with purchases and signed customers up for rewards program.
• Resolved and balanced cash drawers at end of shifts to generate accurate reports for cash registers.
• Scanned, priced and bagged customer groceries quickly to keep lines moving.
• Trained new team members in cash register operation, stock procedures and customer services.
• Monitored checkout counters and self-checkout areas to assist with complex transactions