Genesia Harris
Crawfordville,FL
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
20
20
years of professional experience
Work History
Research Representative 2
Acentra Health
04.2020 - Current
- Tracked key metrics and developed spreadsheets and data models.
- Conducted primary and secondary research to better understand customer needs and behaviors.
- Utilized specialized software to capture and process data.
- Established and managed relationships with external providers and client.
- Used various market research tools and techniques to gather, analyze and interpret data.
- Analyzed data to uncover insights and identify key opportunities to inform strategic decisions.
- Worked effectively in fast-paced environments.
- Successfully communicated with entities inside and outside of business.
- Collected and analyzed data and feedback to identify opportunities to improve relationship between other entities and business.
- Devised and implemented processes and procedures to streamline operations.
- Evaluated staff performance and provided coaching to address inefficiencies.
- Maintained database systems to track and analyze operational data.
- Educated staff on organizational mission and goals to help employees achieve success.
- Conducted regular reviews of operations and identified areas for improvement.
- Collected, arranged, and input information into database system.
- Provided reporting for forecast analysis and ad-hoc reporting in support of decision-making.
Liaison Associate
Conduent
05.2006 - 03.2019
- Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology
- Checked claims coding for accuracy with ICD-9/10 standards
- Performed with precision by entering data accurately and researching to resolve questions
- Reviewed all claims for accurateness and appropriateness
- Accurately entered procedure codes, diagnosis codes and patient information into mainframe system
- Process debits and credits for the client
- Knowledge of processing Prior Authorization requests
- Handled escalated Enrollment requests from the client
- Knowledge of resolving, adjusting and keying medical claims
- Responsible for handling escalated for Congressional/National Office and management
- Experience in direct communication and contact with the client and Vocational Rehab Specialists.
- Optimized customer experience by delivering superior services and effectively troubleshooting issues.
- Developed effective improvement plans in alignment with goals and specifications.
- Helped meet changing demands by recommending improvements to business systems or procedures.
- Analyzed customer data to identify trends and anticipate customer needs.
- Maintained confidentiality of patient demographic, medical and financial information.
- Maintained compliance with legal and medical requirements, internal protocols and oversight committee standards.
- Performed billing and coding procedures for ambulance, emergency room, inpatient, and outpatient services.
Resolutions Associate
Conduent
09.2004 - 05.2006
- Responsible for reviewing and resolving over 500 medical claims daily
- Verified medical claims for accuracy
- Responsible for releasing bills for final adjudication
- Maintained knowledge of all medical terminology and procedures
- Responsible for processing Prompt Pay claims for Nurse and Vocational Rehab Specialists
- Processed medical claims for catastrophic claimants and Providers on review.
Education
Associate of Arts -
Tallahassee Community College
Tallahassee05.2018
Skills
- Critical thinking
- Data entry
- Quality-oriented team player
- Understands medical bill processing procedures
- Quantitative Research
- Strong analytical skills
- Communications management
- Data Collection
- Client Relationship Management
- Professionalism
- Task Prioritization
- Data collection processes
- Data Interpretation
Timeline
Research Representative 2
Acentra Health
04.2020 - Current
Liaison Associate
Conduent
05.2006 - 03.2019
Resolutions Associate
Conduent
09.2004 - 05.2006
Associate of Arts -
Tallahassee Community College
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