Mia Bowers
Buckeye,AZ
Summary
Detail-oriented professional transitioning back into healthcare, applying expertise in compliance and data management. Pursuing certification in Cancer Registry Management, focusing on oncology data collection and coding. Background in regulated industries strengthens ability to manage complex information effectively, supporting quality patient care and advancing cancer research.
Overview
6
6
years of professional experience
Work History
Senior Medical Claims Examiner
ACE/ESIS
Southfield, Michigan
09.1999 - 05.2003
- Conducted audits of claims for compliance with company standards, enhancing quality control and accuracy.
- Monitored trends in rejected and denied claims, identifying areas for strategic adjustments to improve outcomes.
- Mentored junior examiners on best practices and regulatory guidelines, enhancing team compliance and expertise.
- Maintained accurate records of claim activities within computerized database systems, ensuring reliable data access and reporting.
Medical Claims Representative
Seattle School District
Seattle, Washington
08.1997 - 08.1999
- Conducted quality assurance reviews of completed work prior to submission, improving claim accuracy and ensuring timely payment.
- Reviewed medical claims for accuracy and compliance, ensuring adherence to district policies and minimizing potential rejections.
- Collaborated with healthcare providers to gather necessary documentation, expediting processing of claims.
- Updated and maintained accurate records in electronic health systems.
Education
Certification - Cancer Registry Management
University of Cincinnati
Cincinnati, OH08-2027
Associate of Applied Science - Legal Studies
Kaplan University
Davenport, IA05-2014
Diploma - Medical Billing And Coding
Dorsey Business School
Madison Heights, MI05-1994
Skills
- Healthcare regulations- Committed to maintaining HIPAA compliance and ensuring data confidentiality and security
- Cancer registry management- (Student) Proficient in medical record review and extracting oncology-specific data for accurate case reporting Experience with CRStar
- Coding and Staging-Experience with ICD-O coding, AJCC staging, and SEER guidelines for standardized cancer classification
- Medical Knowledge- Solid understanding of medical terminology and anatomy & physiology as applied in cancer data collection
- Cancer Program Standards-Understand regulatory requirements and reporting standards of the Commission on Cancer (CoC), Surveillance, Epidemiology, and End Results (SEER) and North American Association of Central Cancer Registries (NAACCR)
- Data Management- Trained in CRStar: proficient in utilizing tools such as SEER*Rx- Interactive Drug Database for accurate treatment coding
Timeline
Senior Medical Claims Examiner
ACE/ESIS
09.1999 - 05.2003
Medical Claims Representative
Seattle School District
08.1997 - 08.1999
Certification - Cancer Registry Management
University of Cincinnati
Associate of Applied Science - Legal Studies
Kaplan University
Diploma - Medical Billing And Coding
Dorsey Business School