NATASHA BUI

• Blue Cross Blue Shield of Arkansas
• HealthNet inc/Centene
• Maintained strict confidentiality with all personal data as per company guidelines.
• Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
• Examined claims forms and other records to determine insurance coverage.
• Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
• Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
• Managed large volume of medical claims on daily basis.
• Paid or denied medical claims based upon established claims processing criteria.
• Maintained strong knowledge of basic medical terminology to better understand services and procedures.
• Maintained confidentiality of patient finances, records and health statuses.
• Calculated adjustments, premiums, and refunds.

• Arranged for transportation to and from airport, train station and events for visitors..
• Remedied issues quickly and effectively through active listening, conflict resolution and dynamic communication skills.
• Maintained front desk's concierge book to provide visitors with access to relevant local information.
• Participated in team-building activities to enhance working relationships.
• Completed paperwork, recognizing discrepancies and promptly addressing for resolution.
• Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
• Monitored company inventory to keep stock levels and databases updated.
• Exceeded goals through effective task prioritization and great work ethic.
• Maintained excellent attendance record, consistently arriving to work on time.
• Identified issues, analyzed information and provided solutions to problems.
• Learned new skills and applied to daily tasks to improve efficiency and productivity.
• Resolved problems, improved operations and provided exceptional service.

• Leveraged nursing process to individualize patient care in health care setting.
• Assisted in learning process by teaching patients to achieve and promote optimal health maintenance and wellness.
• Functioned with accountability as defined in Vocational Nursing Practice Act to perform technical and manual skilled services under clinical direction of licensed physician or registered nurse.
• Correlated relationship between health and nutrition in planning and implementing patient care.
• Organized, adapted and implemented nursing skills related to mobility, personal care and comfort.
• Collaborated with Charge Nurses on evaluation of care plan outcomes, implementing or adjusting interventions accordingly.
• Circulated assigned floor to measure and record patients' fluid and food levels, implementing measures to promote healthy intake and output as necessary.
• Took samples to complete diagnostic and routine assessment tests.
• Evaluated patient histories, complaints and current symptoms.
• Responded to patient requests with appropriate clinical and personal assistance.
• Assessed patients' temperature, pulse and blood pressure and recorded in electronic medical records.
• Documented patient vitals, behaviors and conditions to communicate concerns to supervising Charge Nurse.
• Worked effectively within healthcare teams on successful patient care and healthcare initiatives.
• Provided basic patient care and treatment, such as administering patient meds, taking temperature and blood pressure and dressing wounds.
• Clearly and thoroughly explained diagnoses, treatment options and procedures to patients and loved ones, checking in to verify understanding.
• Helped patients complete day-to-day tasks, including bathing, dressing and eating.
• Helped long-term care residents with bathing, dressing, feeding and other daily living activities.
• Reviewed patient history to verify conditions and current medications.
• Protected patients and healthcare team members from infection by sterilizing equipment and reusable supplies.
• Provided diagnosis information, treatment possibilities, disease management tips and wound care advice to patients, loved ones and caregivers.
• Worked with multidisciplinary team to carry out successful treatment plans for diverse acute and chronic conditions.

• Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
• Corrected ICD9 codes to properly classify insurance claims.
• Handled complaints and grievances using negotiating and problem-solving skills.
• Prepared summaries of damage, payments and policy coverage.
• Worked with other corresponding departments, department supervisors and providers on preparation of evidence and other documentation in preparation for trial.
• Consulted with providers and hospital records when needed.
• Verified insurance claims and determined fair amount for settlement.
• Conducted day-to-day administrative tasks to maintain information files and process paperwork.
• Finalized claims for insurance claim payment release.
• Investigated and processed insurance claims for policyholders.
• Researched claims and incident information to deliver solutions and resolve problems.

Processed Medicare claims, US Treasury claims

and US Treasury re-work claims

• Ensured accurate payments by meticulously reviewing medical records, invoices, and supporting documentation.
• Researched and resolved complex medical claims issues to support timely processing.
• Corrected and processed US Treasury claims that had been re-submitted to billing dept for corrections
• Knowledgeable in Medicare part A & B
• Enhanced claim processing efficiency by conducting thorough investigations and maintaining accurate documentation.