Shadaira Albert
Jackson,MS
Summary
I have 7 years of advanced medical representative, claim processing, data entry, and administrative experience. I have over 5 years of excellent customer service including call center experience as well as account receivable for patients that receive Medicaid / Medicare and other government assistance to set up transportation for rides to and from physicians’ appointments. I have attended an 18-month course program in Medical Billing and Coding Specialist from Delta Technical College in Ridgeland, MS and received a diploma in my field of study. I have advanced knowledge and skills in disability claims, medical claims, evaluation, medical terminology, processing of payments, ICD9/10 Coding and Billing, reviewing medical insurance, scheduling and charting on patients and accounts receivable, I also have advanced skills in dispatching EMS trucks to 911 calls. I am highly ambitious and very eager to learn. Compassionate Mental Health Tech with an understanding of empathy and proactive care. Several years of experience in the field of behavioral analysis. Proficient in implementing specialized programs for individuals with intellectual, mental, emotional and developmental disabilities. Caring and well-organized with outstanding interpersonal, communication, and social skills.
Overview
12
12
years of professional experience
Work History
Mental Health Technician
Brentwood Healthcare of MS
Flowood, MS
05.2022 - Current
- Working and assisting with children with mental behavior.
- Setting appointments with doctors for children's treatments.
- Routine 15-minute check.
- Keeping records for school usage.
- Developed recovery plans including goals and objectives tailored to meet the individual needs of each patient.
- Organized recreational activities for groups of mentally ill patients.
- Attended workshops, seminars, conferences related to Mental Health Aide field.
- Maintained accurate records of client progress and treatments.
- Collaborated with other healthcare professionals to ensure the best possible care for each patient.
- Encouraged positive behavior change through modeling appropriate behaviors.
- Developed strong relationships with clients built on trust and respect.
- Tracked client movement on and off unit by documenting times and destinations.
- Implemented stress-reduction techniques to promote patient relaxation and well-being.
- Engaged patients in therapeutic activities designed to enhance mental wellness and social skills.
Insurance Processor
Spectraforce Technology ( Contract)WFH
Raleigh, NC
03.2022 - 03.2024
- Assisted customers with completing applications for various types of insurance plans.
- Researched and responded to inquiries regarding coverage and eligibility for benefits.
- Advised customers about available products that best suit their individual needs.
- Provided excellent customer service by responding promptly to inquiries and resolving issues quickly.
- Ensured all documentation was complete, accurate, and compliant with applicable laws.
- Process and review medical insurance claims for payments.
- Processed Pharmacy claims and researched bend numbers to ensure accuracy.
- Review CPT and ICD-10 Codes for accurate billing.
- Review medical insurance for prior authorization for services.
- Review insurance plans for possible COB issues.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Facilitated patient payment process for policies online.
Certified Emergency Dispatcher
Pafford EMS
Ridgeland, MS
10.2018 - 03.2023
- Answering 911 emergency calls.
- Assessed the level of urgency for incoming calls using ratings from P1 to P6
- Entered information into the system to facilitate dispatching.
- Proficient in call dispatching techniques
- Obtained CPR/BLS certification
- Trained new hires to be proficient in dispatching calls accurately.
- Notified supervisors of any irregularities or problems encountered during shift operations.
- Maintained accurate records of all incoming calls, including time received, caller's name and address, type of incident reported, response units dispatched and other pertinent information.
- Participated in training sessions designed to improve knowledge base related to job functions.
- Communicated with police officers via two-way radios to provide updates on suspect location or vehicle description when necessary.
- Ensured that all dispatch requests were handled promptly and efficiently.
- Operated a variety of communication equipment such as computers, telephones, radios and other related technology.
Disability Claims Representative
Medical Mall
Jackson, MS
03.2012 - 12.2017
- Provided support to clients throughout the process of disability filing, including paperwork and applications
- Ensured efficient organization and presentation of evidence in legal proceedings
- Executed essential administrative duties including filing documents, making copies, transferring files through web mail, and sending faxes
- Utilized scanning technology to transfer application data into smart sheet and database
- Stamp Application, assisting other workers, and preparing mail.
- Identified trends in denials that may indicate incorrect application of policies or procedures.
- Conducted interviews with claimants, employers, and medical providers to obtain information regarding the claim.
- Performed quality assurance audits on completed files prior to submission for review and approval.
- Interpreted medical diagnosis codes as they relate to determining eligibility for benefits.
- Managed multiple tasks simultaneously while meeting established deadlines.
Education
Medical Billing and Coding Specialist -
Delta Technical College
Ridgeland, MS04.2013
High School Diploma -
Jim Hill HS
Jackson, MS05.2012
Skills
- Advanced medical representative
- Claim processing
- Data entry
- Administrative experience
- Excellent customer service
- Call center experience
- Account receivable
- Medicaid/Medicare
- Government assistance
- Transportation coordination
- Medical Billing and Coding Specialist
- Disability claims
- Medical claims
- Evaluation
- Medical terminology
- Payment processing
- ICD9/10 Coding and Billing
- Reviewing medical insurance
- Scheduling and charting
- Dispatching EMS trucks
- Reimbursement payment
- Pharmacy claims processing
- Customer benefits verification
- Database management
- Mental Health Tech
- Treatment plan organization
- Appointment scheduling
- Routine check
- Providing meals for children
- Record keeping
- Certified Emergency Dispatcher
- Answering 911 emergency calls
- Call grading
- Dispatching system management
- CPR/BLS Certified
- Employee training
- Disability Claims Representative
- Paperwork assistance
- Application filing
- Issue resolution
- Court document preparation
- Phone answering and call transferring
- Filing, copying, faxing
- Application scanning
- Mail preparation
- Medical Billing and Coding Specialist certification
- Accounts Receivable certificate
References
Available Upon Request
Timeline
Mental Health Technician
Brentwood Healthcare of MS
05.2022 - Current
Insurance Processor
Spectraforce Technology ( Contract)WFH
03.2022 - 03.2024
Certified Emergency Dispatcher
Pafford EMS
10.2018 - 03.2023
Disability Claims Representative
Medical Mall
03.2012 - 12.2017
Medical Billing and Coding Specialist -
Delta Technical College
High School Diploma -
Jim Hill HS
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