RAQEAL D. BEARD
Augusta,GA
Summary
Specialize in quality, speed and process optimization. Analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance.
Overview
11
11
years of professional experience
Work History
Inquiry Analysis
Blue Cross Blue Shield Of Alabama
03.2023 - Current
- Retrieved records to facilitate patient coding process.
- Prepared files for archiving and exchanges, tracking file movement and history.
- Developed and updated databases to handle provider data.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Utilized excellent analytical and problem-solving skills to quickly and accurately assess insurance claims.
- Responded to providers inquiries, providing detailed explanations of insurance policies and claims processes.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
- Calculated adjustments, premiums and refunds.
- Communicated verification and authorization status updates with home plan to facilitate decision-making for patient admissions and insurance coverage.
- Maintain production of 120 claims with 97 percent accuracy weekly.
ER Access Coordinator
Piedmont Hospital
04.2015 - Current
- Bed-side registration performed by using Epic
- Obtain copies of necessary identification and insurance cards to scan into system
- Verify all insurance and obtain pre-certification authorization before adding insurance to ER visit
- Calculate and collect patient liable amounts based on insurance deductibles and co-payment percentages
- Review physician's orders to ensure patients are receiving appropriate test for scheduled appointments
- Schedule walk in appointments for Radiology and Sleep studies
- Complete hospital admissions, review doctor orders, bed patient in assigned room within hospital
- File all doctors' orders for further administration review.
ER Desk Operations Specialist
Augusta University Medical Center
06.2016 - 02.2022
- Data entry of patient demographics, and current emergency symptoms to enter patients into IDX
- Enter trauma patients into IDX within hospitals expected time frame based off trauma level
- Responsible for verifying insurance and billing incorrect accounts
- Obtain necessary identification and insurance cards to scan and upload into Onbase
- Conduct patient counseling of financial responsibilities and provide information on availability of financial resources
- Enter data for up to 35 patient registrations per 12-hour shift
- Create patient charts for each registration event to ensure accuracy of each admission
- Schedule follow up clinic visits upon physicians request
- Provide administration support in Adult and Pediatric Emergency Department settings as well as telemedicine
- Assist with implementing new Emergency Department processes and procedures to improve efficiency of registration process
- Adequately training new employees on policies and procedures
- Ensure trainees are retaining records that are being registered
- Train and develop new hires to ensure become effective members of registration team.
Customer Service Representative
CONVERGENT OUTSOURCING
10.2012 - 05.2014
- Experienced in working with multiple computer software applications to include Microsoft Word, Excel, Outlook, and Multi-monitor.
- Educated customers about billing, payment processing and support policies and procedures.
- Responded proactively and positively to rapid change.
- Calculated correct order totals, updated accounts, and maintained detailed records for inventory management.
- Investigated and resolved accounting, service and delivery concerns.
Education
Certification - Medical Billing And Coding
Medical Coding Simplified
Augusta, GA05.2022
Certification - Electronic Health Records
Aiken Technical College
Graniteville, SC05.2014
Skills
- Microsoft Dynamics
- Administrative Support
- Investigate Claims
- Coordinate Referrals
- Medical Billing
- HIPAA Compliance
- IDX Systems
- Data research and analysis
Timeline
Inquiry Analysis
Blue Cross Blue Shield Of Alabama
03.2023 - Current
ER Desk Operations Specialist
Augusta University Medical Center
06.2016 - 02.2022
ER Access Coordinator
Piedmont Hospital
04.2015 - Current
Customer Service Representative
CONVERGENT OUTSOURCING
10.2012 - 05.2014
Certification - Medical Billing And Coding
Medical Coding Simplified
Certification - Electronic Health Records
Aiken Technical College
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