Monique Sharp
Philadelphia,PA
Summary
Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
34
34
years of professional experience
Work History
Patient Service Representative I/ Complex Schedule
Jefferson Health
Philadelphia, PA
05.2024 - Current
- Greeted visitors and established purpose of visit to direct them to the correct area.
- Coordinated schedule of care and service for patients with complex needs that require three or more appointments at any given time.
- Monitored patient flow within the department and communicated any delays to management staff.
- Developed positive relationships with physicians, nurses, administrators, and other staff members.
- Utilized multiple systems such as EMR and EHR software programs for entering data related referrals and authorization was obtained.
- Scanned completed forms, identification and insurance cards.
- Provided excellent customer service while assisting patients with questions regarding registration procedures.
Data and Billing Specialist
PMHCC
Philadelphia, PA
05.2011 - 08.2013
- Determine eligibility through the DPW/NaviNet system
- Update Medical Assistance history information in billing system.
- Investigated and resolved issues to maintain billing accuracy.
- Upload, track request and enter authorizations.
- Assist with specialized data entry and data analysis projects.
- Generate and submit claim batches to ICM payers as scheduled..
- Import EDI files for payment processing.
- Process and Track MA Expedited Enrollment.
Roster Intake Specialist
Independence Blue Cross
Philadelphia , PA
02.2008 - 07.2009
- Input data and set parameters to monitor, and track incomplete rosters, and non-responding offices.
- Perform external follow-up calls to providers that do not respond to Provider Roster mailing.
- Processed paperwork, obtained billing forms and secured confidential information.
- Conduct extensive research of changes and reconciliations in various internal/external systems.
- Work closely with our Business Specialist, Business analysts, and Credentialing Department
- Made outbound calls to providers to obtain information necessary to create or update authorization.
- Issued, gathered and inspected intake forms to confirm correct signatures and information.
Provider Service Representative
Independence Blue Cross
, PA
10.2004 - 02.2008
- Respond to providers and members on a daily basis by providing timely, accurate responses to telephone and written inquiries
- Updated databases with new and modified customer data.
- Referred unresolved customer grievances to designated departments for further investigation.
- Assist providers and facilities with claims submissions, member benefits and eligibility, payment and discrepancies of claims, and check information
- Explain the contents of the Explanation of Benefits, Statement of remittance, offsets, and Coordination of Benefits information
Lead Contact Representative
Internal Revenue Service, IRS
Philadelphia, PA
01.1992 - 10.2004
- Conduct research and investigation for; individual/business delinquent tax returns, financial analysis, account balances and payment options for short term agreements, regular payment agreements, Offer-In-Compromise. Assist with high dollar, sensitive, and congressional cases in a timely fashion according to policy guide lines.
- Kept records of customer interactions or transactions, thoroughly recording details of inquiries.
- Referred unresolved customer grievances to designated departments for further investigation.
- Updated databases with new and modified customer data.
- Respond to oral and written inquiries in a timely fashion, according to agency guidelines and policies.
- Assist, with various internal and external departments in a case resolution.
- Enforce legal actions such as, liens, wage garnishments, levies on personal and business bank accounts; research for seizures of personal/business property, both tangible and intangible.
- Grievances and Appeals
Education
Bachelor of Science - Business Administration
Lincoln University
Lincoln University, PA05.1991
Skills
- Strong Analytical and Problem Solving
- Strong organizational skills
- Excellent Verbal and Written Communication Skills
- Excellent Interpersonal Communication
- Multitasking and Prioritization
- Data Entry and Maintenance
- Negotiation
- Efficient and Detailed Oriented
- Working Knowledge of EPIC, Pear, Availity, Health Partners and Promise
- Appointment Scheduling
- Processing Payment
Volunteer
- CASA OF PHILADELPHIA ( COURT APPOINTED SPECIAL ADVOCATE)
- JEFFERSON HEALTH VOLUNTEER
Membership
- NCNW ( NATIONAL COUNCIL OF NEGRO WOMEN
Timeline
Patient Service Representative I/ Complex Schedule
Jefferson Health
05.2024 - Current
Data and Billing Specialist
PMHCC
05.2011 - 08.2013
Roster Intake Specialist
Independence Blue Cross
02.2008 - 07.2009
Provider Service Representative
Independence Blue Cross
10.2004 - 02.2008
Lead Contact Representative
Internal Revenue Service, IRS
01.1992 - 10.2004
Bachelor of Science - Business Administration
Lincoln University