Kelsha Strobert
Columbia,SC
Summary
Vibrant Utilization Review Assistant at LRADAC with experience in medical billing and coding. Proven ability to advocate for patients while efficiently processing claims and resolving prior authorization issues. Strong communicator with exceptional organizational skills, dedicated to enhancing patient satisfaction and streamlining administrative processes. Committed to achieving optimal outcomes in the Behavioral Health field.
Overview
5
5
years of professional experience
Work History
Utilization Review Assistant
LRADAC
Columbia, SC
01.2024 - Current
- Post insurance payments and completion of claims in a timely manner.
- Monitor inpatient admission reports.
- Request prior authorizations for inpatient services.
- Obtain initial authorizations when they're required.
- Verify Medicaid eligibility, monthly.
- Coordinate and commence peer-to-peer review calls.
- Assist patients with questions and concerns.
- Post payments to patients' accounts.
- Initiate appeals for denied claims and authorizations.
- Monitor claims in the failed claims to retrieve payment for rendered services.
- Log payer notifications.
- Monitor the payer tracking report daily.
- Check the claim and authorization status.
Patient Account Representative
PricewaterhouseCoopers
Columbia, SC
03.2022 - 12.2022
- Worked with outside entities to resolve issues with billing, claims and payments.
- Electronically submitted claims according to compliance guidelines.
- Posted payments and processed refunds.
- Reconciled statements with patient records.
Customer Service Clerk
Cigna
Colorado Springs
11.2019 - 09.2021
- Handled customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to the appointed supervisor.
- Answered constant flow of customer calls with minimal wait times.
- Updated account information to maintain customer records.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
Education
Bachelor of Science - Health Administration
Ashford University
San Diego04-2026
High School Diploma -
Swansea High School
Swansea05-2018
Skills
- Medical Office Administration
- Data Entry
- Medical Billing and Coding
- Medical terminology
- Effective communication
- Patient advocacy
- Claims processing
- Adaptability
- Organizational skills
- Customer service
Accomplishments
CPR & AED Certification, 11/23
Hobbies and Interests
- Reading
- Socializing
- Traveling
- Outdoor Activities
Languages
English
References
References available upon request.
Timeline
Utilization Review Assistant
LRADAC
01.2024 - Current
Patient Account Representative
PricewaterhouseCoopers
03.2022 - 12.2022
Customer Service Clerk
Cigna
11.2019 - 09.2021
Bachelor of Science - Health Administration
Ashford University
High School Diploma -
Swansea High School
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