Jamilla Posely
Lanham,Maryland
Summary
Resourceful Healthcare Billing Representative known for high productivity and efficiency in task completion. Skilled in providing healthcare support services and resolving customer grievances. Specialized in accurate claim submission, effective revenue cycle management, and comprehensive insurance follow-up. Excel in problem-solving, communication, and time management to ensure smooth financial operations within healthcare settings. Adaptability to various work environments. Eligible to work in the US for any employer.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Pharmacy Help Desk
CVS/caremark
Virginia Beach, VA
11.2022 - 05.2024
- Assisted with processing prescription drug claims and ensured correct submission and processing.
- Resolved discrepancies between provider, patient, and insurer data.
- Utilized claims processing software to streamline workflow and increase efficiency.
- Verified insurance information for seamless resolution of claim-related issues.
- Address inquiries from pharmacies, providers, and beneficiaries, clarifying information and providing solutions to various issues.
- Assisted in resolving technical issues related to online prescription transmissions.
- Maintained confidentiality of policyholder information in compliance with HIPAA regulations.
- Ensured proper coding practices by reviewing documentation, identifying errors, and implementing revisions.
- Resolved rejected claims by applying overrides as a last resort.
Benefits Verification Coordinator
US Bioservices- AmerisourceBergen
Carrollton, TX
01.2022 - 10.2022
- Implemented strategies to decrease patient OOP costs through accessing co-pay and manufacturer assistance programs.
- Assessed claims, records, and procedures for coverage approval.
- Adhered to stringent security protocols and guidelines to safeguard patient health records and payment card data.
- Facilitated communication between the physician, service site, and billing department to secure the necessary documentation.
- Accessed databases from third-party insurers to determine benefit coverage.
- Calculated charges, co-insurance, and deductibles to estimate the self-pay amount.
- Captured data in EMR database for payer details, authorization requirements, and coverage limitations.
- Managed and updated patient and insurance records in the company computer system.
- Errors were identified and denied or rejected claims were re-filed promptly to avoid payment delays.
- Sought out opportunities to optimize patients' insurance coverage by analyzing deductibles, projected reimbursement amounts from insurance carriers, and uncovered expenses.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulations, protocols, and third-party billing requirements.
- Initiated friendly follow-ups with patients regarding outstanding claims in order to facilitate timely payment according to agreed-upon contractual obligations on HMO, PPO, and private accounts.
- Accurately recorded procedure codes, diagnosis codes, adverse events, and patient information in PathpointRx
- Utilized effective written and verbal communication skills to provide accurate information to patients, insurance providers, healthcare staff, and office personnel.
- Updated reference materials with Medicare, Medicaid, and third-party payer requirements, guidelines, policies, and accepted insurance plans.
- Transmitted claims to insurance companies for payment and reconciled EOBs.
Customer Service Representative
Department of Human Services
Baltimore, MD
11.2020 - 08.2021
- Managed and resolved challenging customer issues while ensuring a positive and amicable approach.
- Ensuring accurate documentation of customer conversations for request tracking, problem solving and solution implementation.
- Fielded customer complaints and queries, fast-tracking them for problem resolution.
- Upheld strict quality control policies and procedures during customer interactions.
- Managed high volume inbound calls on a daily basis, efficiently routing them to appropriate individuals or departments.
- Shared detailed information regarding options to help customers make decisions.
- Reviewed account and service histories to identify trends and issues.
- Ensured quick resolution of routine queries and customer grievances with a courteous demeanor.
- Utilized CRM, Jabber, and CARES to perform listed duties.
Pharmacy Technician
CVS Health
Bowie, MD
06.2019 - 06.2020
- Provided support for staff in managing drug inventory and purchases.
- Accurately filled prescriptions to fulfill customer's medication needs.
- Managed inventories, rotated stock, removed expired or damaged drug products, and resolved discrepancies in drug counts.
- Conducted research on customer health insurance plans to facilitate prescription authorization and enhance patient care.
- Resolved third-party rejection claims using RxConnect.
- Implemented regular updates to customer profiles with accurate changes in demographics, allergies, and medications in pharmacy computer systems.
- Verified prescriptions with 8-point check system to ensure accuracy and efficiency.
- Confirmed prescriptions for patients by placing calls and conferring with physicians' office staff.
- Actively liaised with insurance providers to facilitate claim processing, troubleshoot problems, and attain prompt payments.
- Prepared requisitions for drugs and supplies, as necessary.
- Merchandised related products to drive pharmacy department sales.
- Handled requests for prescription transfers from/to competing pharmacies.
- Collaborated closely with the pharmacist to deliver a high level of quality care to patients and patrons.
- Processed cash register transactions efficiently for both new and refill prescription orders.
- Processed and recorded an average of 500 medication orders daily in the system.
- Maintained clean and organized pharmacy shelving and work areas.
- Complied with regulatory guidelines for workplace safety and maintained customer confidentiality.
Pharmacy Technician
Walgreens
Bowie, MD
08.2018 - 03.2019
- Received and verified incoming drug inventories, notifying lead pharmacist of any discrepancies.
- Managed medication inventory by conducting regular stock counts and ensuring proper labeling and rotation of products.
- Merchandised OTC products to drive store sales.
- Compiled customer demographic, allergy, and medical history background.
- Worked collaboratively with insurance providers to streamline claim processing, troubleshoot problems, and ensure swift payment acquisition.
- Eliminated third-party rejection claims through Intercom Plus.
- Increased efficiency by promptly placing orders for medications that were out of stock, ensuring timely delivery to patients' prescriptions.
- Calculated dosage, filled prescriptions, and prepared prescription labels.
- Promoted patience adherence through mobile communication by eliminating any discrepancies or uncertainty.
- Ensured compliance with all federal, state, local laws and company policies related to pharmacy operations.
- Participated in continuing education and training to stay current with pharmacy practices and technology.
- Kept accurate records of controlled substances received and dispensed in accordance with DEA regulations.
- Received payment from customers and processed credit card transactions when necessary.
Guest Services Coordinator
Vita's Hair Studio
Greenbelt, MD
07.2018 - 08.2018
- Interface with customers and sales representatives to handle both pre-sales and post-sales service functions.
- Handle and resolve customer complaints/inquiries via mail or phone in a timely and accurate manner.
- Assist in product purchasing and order fulfillment activities, such as taking orders, giving pricing information, determining appropriate shipping methods, routes, and rates.
- Managed various types of incoming phone calls, including return material requests, product samples inquiries, order referrals, and sales promotions.
- Generated price and cost proposals based on customer queries.
- Contact customers regarding contract cancellations to determine thecause and possible corrective measures.
- Maintain a competent understanding of the company's products, their functions, and alternatives.
- Managed database to track customer sales orders and invoice records.
- Assist in marketing activities and inventory control maintenance.
- Established strong rapport with guests, leaving them with a professional impression of the company.
Dental Assistant/ Receptionist
Bright Starr Pediatric Dentistry
Bowie, MD
12.2016 - 05.2018
- Efficiently managed patient documentation by completing paperwork and digitizing records using the Dentrix system.
- Educated patients about proper oral hygiene and plaque control procedures.
- Confirmed patient insurance benefits and checked claim statuses.
- Performed administrative duties such as scheduling appointments, answering telephones and updating patient records.
- Helped maintain inventory levels of all dental supplies used in day-to-day operations.
- Handled billing inquiries from insurance companies regarding claims submitted by the office.
- Sustained cleanliness of equipment and treatment rooms by sanitizing, cleaning, and restocking after every patient's treatment.
- Arranged dental instruments and equipment prior to procedures.
- Explained dental services and payment plans to help patients make informed decisions.
- Provided administrative support to staff members including typing letters, filing documents, and scanning and copying documents when necessary.
- Maintained a neat reception area by organizing materials and tidying up furniture.
- Processed customer payments using cash registers or point-of-sale terminals according to company policies and procedures.
Dietary Aide
Hillhaven Assisted Living Facility
Adelphi, MD
08.2016 - 11.2016
- Planned and prepared a variety of delicious and nutritious dishes using diverse food combinations.
- Recorded and tracked detailed information on food served, preparation methods, portion sizes, and patient benefits.
- Performed diligent sanitation duties, including washing dishes, carts, and racks, as well as storing cleaned dishes.
- Documented temperatures and stock inventory.
- Served specific meals to patients with special dietary restrictions and allergies.
- Contributed to daily meal prep while strictly following guidelines for sanitation and food safety
- Maintained the cleanliness of the dining room before and after each meal service.
- Arrange trays and food service carts for delivering meals to residents.
- Stocked supplies in dining areas as needed.
- Observed special diets prescribed by physicians or nutritionists.
- Informed supervisor about any changes in patient's dietary needs or preferences.
- Assisted in the ordering, receiving, storage, and inventory of food items.
- Gathered soiled tablecloths and dietary linens and delivered to laundry.
Crew Member
Domino's Pizza
Hyattsville, MD
05.2016 - 08.2016
- Managed high call volume with tact and professionalism.
- Addressed and resolved customer product complaints empathetically and professionally.
- Prepared food orders according to customer preferences.
- Sanitized work space and kitchen area.
- Refilled inventory while sweeping and sanitizing tables and equipment.
- Maintained cleanliness and tidiness of restaurant lobby, front counter, and restrooms during entire shift.Input orders into the computer system to relay order details to the kitchen staff, ensuring customers' special requests and food allergies were communicated directly..
- Processed takeout orders quickly to ensure timely delivery of meals.
- Monitored quality of food served to ensure it met company standards for presentation and temperature.
- Performed cashier duties such as taking orders, collecting payments and providing change.
- Assisted management team with inventory counts of food products and beverage supplies.
- Greeted customers upon arrival, provided menus and answered questions regarding menu items.
- Restocked kitchen supplies including food products and utensils.
Lifeguard
Lifeguard Six Flags, Inc | Upper Marlboro
Upper Marlboro, MD
05.2016 - 08.2016
- Maintain the record of safety for the pool complex at all times by enforcing all posted rules.
- Monitored swimmers and guests entering and exiting the water, ensuring adherence to rules.
- Taking immediate action during water-related crises, including rescue operations, provision of first aid and CPR techniques, and timely coordination with emergency personnel.
- Ensure the pool area and water are kept clean and free from hazards by checking chemical water conditions and water equipment for problems every hour.
- Update guests when there is an issue with the water or other pool facilities in order to keep everyone's health and safety a priority.
- Supervise monthly swimming tests for guests to demonstrate readiness for certain areas of the pool.
- Recommend swimming programs and classes to guests based on questions asked or guest activities at the pool.
- Provide support to swim instructors and pool activity leaders during swimming lessons or water exercise classes, when necessary.
Education
Associate of Science -
Prince George's Community College
Upper Marlboro, MD05.2020
High School Diploma -
Duval High School
Lanham, MD2017
Skills
- ICD-10
- Scriptmed, Avaya, NICE
- PathpointRxBioservices
- RxConnect
- Dentrix
- Intercom Plus
- EMR
- CRM
- Jabber
- CARES
- PBM and Major Medical billing
- Medicaid, Medicare, Private Insurance
- Prior Authorization/ Claims Processing
- First Aid, CPR, and AED certified
- MD Board of Pharmacy Cert
- Medical terminology
- Recordkeeping and data input
- Telephone etiquette
Languages
French
Professional
Certification
- MD Board of Pharmacy Technician Certification since 2019.
Timeline
Pharmacy Help Desk
CVS/caremark
11.2022 - 05.2024
Benefits Verification Coordinator
US Bioservices- AmerisourceBergen
01.2022 - 10.2022
Customer Service Representative
Department of Human Services
11.2020 - 08.2021
Pharmacy Technician
CVS Health
06.2019 - 06.2020
Pharmacy Technician
Walgreens
08.2018 - 03.2019
Guest Services Coordinator
Vita's Hair Studio
07.2018 - 08.2018
Dental Assistant/ Receptionist
Bright Starr Pediatric Dentistry
12.2016 - 05.2018
Dietary Aide
Hillhaven Assisted Living Facility
08.2016 - 11.2016
Crew Member
Domino's Pizza
05.2016 - 08.2016
Lifeguard
Lifeguard Six Flags, Inc | Upper Marlboro
05.2016 - 08.2016
Associate of Science -
Prince George's Community College
High School Diploma -
Duval High School