Joy Moore
St. Louis,MO
Summary
Highly organized and detail-oriented professional with strong work ethic and dedication to achieving goals. Skilled at developing and maintaining documentation systems, managing calendars and preparing reports. Knowledgeable in project management principles, business processes and customer service best practices.
Overview
12
12
years of professional experience
Work History
Coordinator Medical & Government Benefits
School Sisters Of Notre Dame
09.2020 - Current
- Process accounts and incoming payments in compliance with financial policies and procedures medical, dental and specialist care.
- Perform day to day financial transactions, including verifying, classifying, computing, posting and recording accounts receivables’ data
- Prepare bills, invoices and bank deposits
- Reconcile the accounts receivable ledger to ensure that all payments are accounted for and properly posted.
- Verify discrepancies by and resolve clients’ billing issues
- Facilitate payment of invoices due by sending bill reminders and contacting clients
- Generate financial statements and reports detailing accounts receivable status ICD codes
- Reviewing and appealing unpaid and denied claims
- Verifying patients’ insurance coverage
- Answering patients’ billing and payment questions
- Identifying and resolving patient billing complaints
- Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing
- Following up on unpaid claims within standard billing cycle timeframe
- Expert on medical coverages Medicaid, Medicare health care coverages
- Improved team productivity with regular communication and progress updates, fostering a collaborative work environment.
- Streamlined administrative processes, allowing for more efficient use of resources and better support for project teams.
Medical Care Coordinator
Blue Cross And Blue Shield Of Illinois
07.2019 - 08.2020
- Creating and submitting medical claims to patients and insurance companies, ensuring accuracy and completeness.
- Checking patient insurance coverage and eligibility before billing.
- Following up on unpaid claims and initiating appeals for denied ones within standard billing cycle timeframes.
- Handling patient inquiries about bills, offering explanations, and setting up payment plans for those unable to pay in full.
- Collaborating with medical coders and other healthcare professionals to ensure accurate billing and to resolve discrepancies.
- Navigating and maintaining electronic health records (EHR) and billing software, posting payments to patient accounts.
- Benefit analyst for private sector, and government benefits. Responsible for performing telephonic or face-to-face and program needs
- Assisted in the development of quality improvement initiatives, resulting in enhanced efficiency of medical care coordination processes.
- Advocated on behalf of patients, helping them navigate complex insurance policies and secure necessary coverage for medical services.
- Enhanced patient satisfaction by efficiently coordinating medical care and addressing individual needs.
- Conducted admissions assessments to determine patient conditions and risk levels.
- Conducted regular reviews of case files to identify areas for improvement or additional support needed for successful outcomes.
Lead Clinical Administrative Coordinator
United Health Group, Optum
10.2017 - 06.2019
- Lead a team of Clinical Administrative Coordinator
- Train new staff point of contact when issues occur.
- Accurately create and issue invoices for products or services rendered, ensuring all necessary details such as item descriptions, quantities, and terms of payment are included.
- Input and maintain accurate records of all invoices in the accounting system, ensuring data integrity and easy retrieval for future reference.
- Monitor incoming payments, process transactions, and update records accordingly to reflect payments received, outstanding balances, and payment statuses.
- Serve as the primary point of contact for clients regarding invoicing inquiries, addressing questions about charges, payment terms, and discrepancies in a professional manner.
- Investigate and resolve billing disputes or discrepancies by collaborating with clients and internal teams, ensuring timely resolution to maintain positive client relationships.
- Regularly reconcile accounts receivable to ensure that all invoices are accounted for and that discrepancies are identified and resolved issues.
- Generate and analyze reports on invoicing activities, outstanding invoices, and payment trends to provide insights to management and assist in financial forecasting
- Maintained complete documentation for permanent records and auditing purposes.
- Facilitated communication between patients, healthcare providers, and insurance companies to ensure accurate billing and reimbursement.
- Verified and reconciled service charges with insurance companies and payment providers.
Program Coordinator
Centene
06.2016 - 09.2017
- Facilitated regular meetings with team members to discuss progress updates, address challenges, and brainstorm solutions for ongoing success.
- Maintained detailed records of program activities and participant data, ensuring compliance with internal policies and external regulations.
- Provided exceptional customer service to program participants through prompt response times and attentive assistance with inquiries or concerns.
- Developed marketing materials to promote program offerings, increasing awareness and participation rates among target audiences.
- Managed budgets and resources for successful execution of multiple programs simultaneously.
- Assisted in the development of grant proposals, securing funding for vital program initiatives.
- Delegating tasks to appropriate team members
- Managing deadlines and progress across the team to ensure the project is delivered on time and on budget
- Organizing third-party providers and vendors to deliver elements that can’t be produced in-house
- Overseeing the delivery of projects and making adjustments as necessary to ensure they are delivered to specifications and high standards
- Collecting and analyzing feedback from customers and other project users to gauge satisfaction and success
- Provided exceptional customer service, addressing inquiries and resolving issues promptly.
- Improved team collaboration with establishment of regular coordination meetings and updates.
- Established strategic partnerships with external organizations, expanding program reach and impact.
Field Outreach Coordinator
WellCare Healthcare Plan
10.2014 - 05.2016
- Developed partnerships with relevant stakeholders, strengthening the organization''s presence in the community.
- Monitored progress towards outreach goals regularly, making adjustments as needed to ensure continued success of initiatives.
- Issuing invoices and billing statements to clients, and following up on these documents
- Keeping track of all payments and ensuring they are correctly applied to customer accounts
- Identifying delinquent accounts and insufficient payments
- Communicating with customers regarding their outstanding balances and payment deadlines
- Collaborating with the sales and customer service departments to resolve billing disputes
- Preparing reports on accounts receivable status
- Implementing and maintaining internal controls to ensure compliance with company policies and accounting principles
- Processing refunds and write-offs
- Provide community resources for payment
- Collaborated with interdisciplinary teams to develop comprehensive plans for addressing community needs.
- Provided leadership, guidance and support to staff members, providers and health organizations
Community Support Specialist
Hopewell Behavioral Health Centers, Inc.
03.2013 - 08.2014
- Conduct comprehensive assessments to determine individuals’ mental, emotional, and behavioral health needs
- Develop personalized treatment plans in collaboration with clients and their families
- Provide individual and group therapy services to help clients manage mental health conditions
- Work alongside other healthcare professionals to provide holistic care to clients
- Refer clients to appropriate resources and services within the community
- Advocate for clients’ rights and needs within the healthcare and social service systems
- Monitor clients’ progress and adjust treatment plans as necessary.
- Creating and submitting medical claims to patients and insurance companies, ensuring accuracy and completeness.
- Checking patient insurance coverage and eligibility before billing.
- Following up on unpaid claims and initiating appeals for denied ones within standard billing cycle timeframes.
- Handling patient inquiries about bills, offering explanations, and setting up payment plans for those unable to pay in full.
- Collaborating with medical coders and other healthcare professionals to ensure accurate billing and to resolve discrepancies.
- Educate clients and their families about mental health conditions and coping mechanisms
- Keep detailed records and reports to track client progress and for use in case management
- Follow confidentiality and ethical guidelines when handling sensitive professional clinical information.
Education
Bachelor - Health Administration,
Harris Stowe University
St. Louis, MO01-2026
CDA - Child Development
St. Louis Community College At Forest Park
St. Louis, MO01.2001
Certificate - Community Health Worker
Region 6 South Central Public Health
Skills
- Billing & Coding
- Medicaid
- CRM software
- Data entry
- Decision-making
- Database management
- Customer service
- Microsoft Office
- Microsoft Excel
- Appeals & Grievance
- Managed Care
- Behavioral Health
- Meeting Facilitation
- Accounts receivable
- Staff supervision
Timeline
Coordinator Medical & Government Benefits
School Sisters Of Notre Dame
09.2020 - Current
Medical Care Coordinator
Blue Cross And Blue Shield Of Illinois
07.2019 - 08.2020
Lead Clinical Administrative Coordinator
United Health Group, Optum
10.2017 - 06.2019
Program Coordinator
Centene
06.2016 - 09.2017
Field Outreach Coordinator
WellCare Healthcare Plan
10.2014 - 05.2016
Community Support Specialist
Hopewell Behavioral Health Centers, Inc.
03.2013 - 08.2014
Bachelor - Health Administration,
Harris Stowe University
CDA - Child Development
St. Louis Community College At Forest Park
Certificate - Community Health Worker
Region 6 South Central Public Health
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