MaSheena Brown
Orlando
Summary
Effectively control insurance risk with thorough reviews of claims as a successful Claims Representative. Diligently verify information, document findings and negotiated settlements. Skilled Medical Assistant with expertise in caring for at-risk populations with immunizations and basic diagnostics. Coordinates referrals for specialized care and support services. Good record keeping and program management abilities. Authorized to work in the US for any employer Dedicated administrative professional with successful experience in fast-paced office settings. Hardworking team player with expertise in completing various clerical tasks and offering staff support. Responsible, punctual and productive professional when working with little to no supervision.
Overview
20
20
years of professional experience
Work History
Unit Secretary
Orlando Regional Medical Center
05.2023 - Current
- Managed incoming calls and directed to appropriate department.
- Maintained patient confidentiality in line with HIPAA regulations.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Organized paperwork such as charts and reports for office and patient needs.
- Maintained rapport with physicians, nurses and other healthcare personnel.
- Maintained current and accurate medical records for patients.
- Provided information for patient admissions and discharges to foster timely processing.
- Executed administrative duties to facilitate unit tasks and meet team goals.
- Monitored inventory levels and advised management of need for replenishment.
- Performed various administrative tasks by filing, copying and faxing documents.
- Placed new supply orders, managed inventory and restocked clerical spaces.
- Organized and maintained patient chart filing system to promote quick data finding for staff.
- Received and routed laboratory results to correct clinical staff members.
Medicaid Specialist
Centene Corporation
11.2020 - Current
- Acts as primary liaison with callers; follows medicaid specifications in assisting with questions and solving problems related to the claims application and servicing processes
- Educates and informs the customer multiple communication channels about documentation required to process a claim, required time frames, payment information, and claim status
- Educates claimants/callers on client requirements and benefit plans documenting all required details of the call in a concise professional manner
- Enters verbal and written application information that meets both the internal and external customer's requirements accurately into the claims management system
- Directs customer calls to the appropriate contact at multiple locations or escalates to Service management as needed.
WAH-Claims Representative
SEDGWICK CMS
10.2015 - 11.2020
- Acts as primary liaison with callers; follows client specifications in assisting with questions and solving problems related to the claims application and servicing processes
- Educates and informs the customer multiple communication channels about documentation required to process a claim, required time frames, payment information, and claim status
- Educates claimants/callers on client requirements and benefit plans documenting all required details of the call in a concise professional manner
- Enters verbal and written application information that meets both the internal and external customer's requirements accurately into the claims management system
- Directs customer calls to the appropriate contact at multiple locations or escalates to Service management as needed.
Customer Service Representative II
Accredo Health Group
11.2012 - 09.2015
- Works closely with physician's offices and on occasion the customer to obtain all required documentation pertaining to our customers' orders
- Manage Fax queues daily, make outbound calls to physicians' offices and customers
- Take inbound calls from customers and physicians' offices as required
- Acts as primary liaison with callers; follows client specifications in assisting with questions and solving problems related to the claims application and servicing processes
- Educates and informs the customer multiple communication channels about documentation required to process a claim, required time frames, payment information, and claim status
- Educates claimants/callers on client requirements and benefit plans documenting all required details of the call in a concise professional manner
- Investigate claims
- Vital sign monitoring
- Clinical and administrative support
- Enters verbal and written application information that meets both the internal and external customer's requirements accurately into the claims management system
- Directs customer calls to the appropriate contact at multiple locations or escalates to Service Center
- Specialist/management as needed.
Medical Assistant/Phlebotomist
Richard MDS
01.2009 - 09.2012
- Performed nonprofessional nursing care, setting appointments, clerical functions, receptionist duties, record keeping tasks associated with patient care and treatment
- Record blood pressure, pulse, respirations, temperature, height, and weight; measures and records intake and output; urine dips and recordings, pap smears, and etc
- Received nurse calls and called in prescriptions for patients.
Customer Service Representative II
CVS Caremark
11.2008 - 12.2009
- Assisting patients, doctor's offices and other insurance companies with information concerning the patients that have accounts within CVS/Caremark's insurance data base
- Filling prescriptions and answering questions about the patients insurance and prescriptions.
Medical Assistant/Phlebotomist
Centennial Pediatrics
11.2005 - 11.2008
- In any of several areas
- Performed nonprofessional nursing care, appointment clerical functions, receptionist duties, record keeping tasks associated with patient care and treatment, or a combination of all these functions as required in some of the areas
- Taken and recorded blood pressure, pulse, respirations, temperature, height and weight; measures and records intake and output; obtains pulse ox meter readings and notifies doctor for abnormal readings per protocol
- Received telephone calls, patients, and visitors to the medical facility, ascertains the nature of the call or visit.
Education
Associate of Applied Science - Nursing
Rasmussen University
Orlando, FLDiploma - Medical Assisting
Concorde Career College
Memphis, TNHigh School Diploma -
The Academies Of West Memphis Charter School
West Memphis, ARSkills
- Review cases
- Verify data
- Patient assessments and care
- Insurance Verification
- Medical Billing
- Medical Scheduling
- Medical Records
- Medical Terminology
- Quality Assurance
- ICD-10
- Program Management
- Medical Coding
- CPT Coding
- Typing
- Medical office experience
- Microsoft Office
- Computer skills
- EMR systems
- Data Entry
- Electronic Recordkeeping
- BLS Certified
- Customer Service
- Documentation and Recordkeeping
- Administrative Support
- HIPAA Compliance
Timeline
Unit Secretary
Orlando Regional Medical Center
05.2023 - Current
Medicaid Specialist
Centene Corporation
11.2020 - Current
WAH-Claims Representative
SEDGWICK CMS
10.2015 - 11.2020
Customer Service Representative II
Accredo Health Group
11.2012 - 09.2015
Medical Assistant/Phlebotomist
Richard MDS
01.2009 - 09.2012
Customer Service Representative II
CVS Caremark
11.2008 - 12.2009
Medical Assistant/Phlebotomist
Centennial Pediatrics
11.2005 - 11.2008
Associate of Applied Science - Nursing
Rasmussen University
Diploma - Medical Assisting
Concorde Career College
High School Diploma -
The Academies Of West Memphis Charter School