Estella Keubke
The way to get started is to quit talking and begin doing.
Walt Disney
Summary
Organized and dependable Revenue Cycle Management Specialist with experience in ERA/EFT Enrollments. Proficiency with electronic health records (EHR) systems and clearinghouse platforms. Prior Authorizations, Referral Management and Customer Service skills. Experienced in medical terminology, proficient in Excel, Outlook, Word, ICD10 and CPT Coding.
Overview
20
20
years of professional experience
1
1
Certification
Work History
ERA and EFT Enrollment Professional
Ensemble Health Partners
10.2023 - Current
- Managing and processing ERA/EFT enrollments for healthcare providers and facilities
- Maintaining multiple spreadsheets for each Healthcare provider
- Working effectively in fast-paced environments.
- Managing insurance payers, ensuring accurate and timely submission of necessary enrollment applications and documentation
- Working with the various clearinghouses, as well as maintaining payer portals for monthly maintenance
- Coordinating with internal teams, to facilitate smooth electronic data interchange (EDI) and billing processes for patient claims
- Working with the Billing and Cash management teams to keep track of EOBs (remits) and ACH payments
- Working with internal teams to locate and resolve missing remits (EOBs)
- Researching issues with ACH payments that have reverted back to check payments
- Monitoring the submission of ERA enrollments through clearinghouses. Also addressing any rejections or errors
- Typing speed 45-55 WPM alpha/numeric
- Microsoft Excel/Microsoft Office/Outlook/Teams experience
Data Entry Clerk III
Aetna, a CVS Health Company
11.2022 - 06.2023
- Created and maintained multiple EFT request data entry logs for assigned provider states
- Responded to emails from Healthcare providers requesting Electronic Funds Transfers enrollment
- Utilized the Provider Payment Setup portal to enroll Healthcare providers
- Verified TIN/NPI numbers for each provider in QNXT
- Verified and confirmed all banking information for EFT requests
- Scanned and corrected all information for rejected EFT requests to resolve and re-enroll
- Typing speed 45-55 WPM alpha/numeric
- Data Entry
- Customer Service
- Minimum of 60 calls per day
- Microsoft Excel/Microsoft Office/Outlook/Teams experience
Care Review Processor II
Molina Healthcare
10.2021 - 05.2022
- Star Plus Medicaid experience
- QNXT portal experience
- Faxed MD certification letters for physician signature/approval
- Sending Medicaid cases for escalation
- Updating member cases
- Maintained confidentiality at all times while handling sensitive patient information according to HIPAA regulations
- Data entry
- Typing speed 45-55 WPM
- Customer service
- Microsoft Excel/Microsoft Office/Outlook
- Required daily production of 80%
Prior Authorization Coordinator
Equity Staffing
01.2019 - 05.2019
- Verified eligibility and compliance with authorization requirements.
- Prepared prior authorizations for Nurse's review
- Faxed authorization approval/denials to providers
- Medicare experience
- CMS guideline knowledge
- Medical records labeling/uploading
- Prepared and distributed approval/denial letters to patients
- EMR experience
- Right fax knowledge
- Customer service
- Data entry
- 45-55 WPM
- Microsoft Excel/Outlook/Teams experience
- Medical terminology
- ICD 10 & CPT codes knowledge
- Required daily production of 80%
Medical Data Entry Specialist
Humana Military Health Services
10.2004 - 10.2013
- Processed internet referrals/authorizations
- Managed UC authorizations/out of region authorizations
- Located specialty healthcare for TriCare patients
- Handled all Active Duty and Retiree and family insurance claims
- Maintained all hospital stays
- Experienced with continuation of healthcare issues
- Obtained discharge dates
- MTF contact for request for civilian care
- Alpha/numeric data entry
- Excel/ Word/Microsoft Office
- ICD-9/CPT Coding
- Ran LCD (Last Call Date) hospital reports
- Received daily audits; scores of 98-100% accuracy
Education
Associate's degree - Business Management
05.2017
Certification - Medical Administrative Assistant
06.2002
Skills
- Experience with EMR Software
- Medical Record Management
- Effective Problem Solver
- Strong Organizational Abilities
- Excel Proficiency
- Medical terminology
- Proficient in ICD-10 Classification
- Detail Orientation
- Knowledge of Healthcare Practices
- Effective communication skills
- Workflow optimization
- Referral management
Certification
Certified Revenue Cycle Representative (CRCR)
05/01/24 - 05/31/26
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimeContract WorkWork Location
RemoteImportant To Me
Career advancementWork-life balanceFlexible work hoursWork from home optionPaid time off401k matchCompany CultureLanguages
English
Professional Working
Accomplishments
At year end 2024 Profit and Loss evaluation for quarter 4, I assisted 4 of my 7 Healthcare facilities recover over $900,000 each after a substantial loss in quarter 3, which was a 2.5% increase.
This increase also aided our company overall to meet its goal for 2024, which in-part made it possible for everyone to receive a well deserved bonus for all the hard work.
Timeline
ERA and EFT Enrollment Professional - Ensemble Health Partners
10.2023 - Current
Data Entry Clerk III - Aetna, a CVS Health Company
11.2022 - 06.2023
Care Review Processor II - Molina Healthcare
10.2021 - 05.2022
Prior Authorization Coordinator - Equity Staffing
01.2019 - 05.2019
Medical Data Entry Specialist - Humana Military Health Services
10.2004 - 10.2013
National Institute of Technology - Certification, Medical Administrative Assistant
Career Point College - Associate's degree, Business Management
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