Michelle Justice
Winter Haven,FL
Summary
Self-motivated and available for an opportunity to offer professionalism, experience, and thoroughness in the consistently changing business industry. A position not only to challenge myself but to fully utilize acquired leadership skills and abilities.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Accounts Payable Clerk
OptumCARE
Remote
08.2022 - Current
- Respond to vendor inquiries and internal emails in timely manner
- Investigate and resolve immediate issues with accounts such as credit holds or past-due amounts
- Ensure final payments to vendors from recent acquisitions when contracts end
- Process invoices as arrive to be processed promptly
- Follow standard procedures to complete requests.
Clinical Administrative Coordinator
OptumRx Infusion Services
Remote
10.2021 - 08.2022
- Provide/explain benefits and authorization information to members/providers
- Communicate with clinical team to ensure provider receives a response when necessary -Document call history information into relevant computer system
- Enter medical request data into relevant computer system
- Follow standard procedures to complete requests
- Request medical review via relevant computer system as needed
- Review and advise member/provider of status of a request (e.g., notification, authorization) Schedule appointments for members based on request -Provide information regarding appointments and medical services to facilities staff to assist members.
Senior Claims Adjuster and Assistant Trainer
Government Employee Health Association (GEHA)
Independence
06.2013 - 10.2021
- Self-managed to ensure entry accuracy and efficient processing
- Member of Batch team to implement AI process and ensure accuracy
- Worked as Assistant Trainer within the training department
- Continuous on-floor extended training and coaching.
- Lead process improvement and implementation to identify solutions to Desk Level Procedures
- Participating in Open Season for training of client-level services
- Work closely with departments across the organization to research claims and inquiries in prompt, courteous and accurate manner.
- Proactive problem resolution to create process improvement with management
- Processing of claims including by not limited to coordination of benefits, handling adjustments and correspondence with a max value of 1m
- Trained as a resource on dental, transplants, High dollar hospital, internal employee, provider records, hospital stay preapproval and various other internal groups.
Office Manager Assistant
Allied Construction Services Inc.
01.2001 - 08.2011
- Light bookkeeping and accounting in the processing of weekly and monthly certified union payroll for all projects across the Kansas City Metro Area
- Process and handle Human Resource needs for employment paperwork and orientation.
Attendance Management
USA 800
Raytown
12.2010 - 01.2011
- Maintain attendance records for companywide staffing
- Human Resource duties of all Employees, including new hires, terminations, and corrective action plans.
- Developed and maintained courteous and effective working relationships.
- Demonstrated strong organizational and time management skills while managing multiple projects.
- Developed strong organizational and communication skills through coursework and volunteer activities.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
Education
Associate of Applied Science Management Degree -
National American University
Overland Park, KS07.2023
Skills
- Department Training/Auditing
- Accounting ledger maintenance
- Vendor invoice processing
- Data Entry and 10-Key
- Customer Relations
- MS Office Suite
- Quality Review/Audit
- Medical Claims Processing /Adjustor
- Certified Medical Billing and Coding
- Prior Authorization for Acute Team
- OneNote
- Invoice Processing
- Critical Thinking
- Time Management
- Accounts Payable Software
- General Ledger Management
Certification
aapc certification cpc-a, 09/2020
References
- Rosemarie (Rosie) Rescica, Clin Admin Coord SME, OptumRx Infusion Services, rrescica@optum.com, 877-306-4036
- Dylan R Kaps, Supervisor Clinical Admin, OptumRx Specialty/Infusion, Dylan.r.kaps@optum.com, 763-957-6370
- Letitia (Tisha) Smith, Assoc. Director of Accounting, OptumCare Mtn West Region, Letitia.smith@optum.com, 702-304-6955
Timeline
Accounts Payable Clerk
OptumCARE
08.2022 - Current
Clinical Administrative Coordinator
OptumRx Infusion Services
10.2021 - 08.2022
Senior Claims Adjuster and Assistant Trainer
Government Employee Health Association (GEHA)
06.2013 - 10.2021
Attendance Management
USA 800
12.2010 - 01.2011
Office Manager Assistant
Allied Construction Services Inc.
01.2001 - 08.2011
Associate of Applied Science Management Degree -
National American University