Shaqwan Fincher
Charlotte,NC
Summary
Dedicated professional with 8 years of experience, including a customer service role at Humana/Concentrix, seeking a customer support position. Expertise in accurate data entry, policy processing at Total Med/Centene, and maintaining high customer satisfaction. Proven ability to manage sensitive information, adhere to compliance standards, and deliver exceptional service. Ambitious Quality Analyst with track record of dependability and leadership. Knowledgeable in QA methodology with proven history of reducing errors to increase quality. Proficient in preparing test cases, plans, and scripts. Dedicated to analyzing and resolving defects.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Medical Coder
Humana Medical Insurance Remote
11.2020 - 04.2023
- Assigned ICD and CPT codes to patient records with a consistent 97% accuracy rate across approximately 150 daily claims
- Conducted thorough reviews of patient charts to identify and rectify discrepancies in medical documentation
- Utilized radiology information systems for computer-assisted coding, ensuring precise translation of medical terminology into applicable codes
- Analyzed Diagnosis-Related Group (DRG) assignments, employing ICD-9-CM codes to optimize billing accuracy and compliance.
Production/Assembly
Alsco Charlotte, NC
05.2014 - 07.2015
- Efficiently operated material handling equipment, meeting production targets to sustain operational efficiencies
- Fostered a collaborative work environment through effective communication, enhancing cooperation among customers, vendors, and team members.
Customer Service Representative
Humana/Concentrix
05.2014 - 07.2015
- Achieved enrollment targets for patient medication through effective communication and guidance
- Maintained a positive customer service atmosphere, addressing inquiries via phone, email, and fax regarding eligibility, benefits, claims, and billing issues
- Demonstrated technical proficiency by rapidly acquiring expertise in five distinct operational skills, resulting in recognition with incentive pay on two occasions.
Cashier/Customer Service Representative
McAllister Deli Charlotte, NC
06.2015 - 08.2016
- Delivered exceptional customer service by attentively greeting and assisting patrons, ensuring a high satisfaction rate through professional interaction and accurate order preparation
- Managed opening and closing duties with diligence, contributing to the seamless daily operations of a fast-paced retail environment.
Cashier
Wendy's Monroe, NC
01.2017 - 03.2017
- Delivered exceptional customer service by courteously processing transactions and addressing additional purchase requests, enhancing the overall customer experience
- Managed end-of-day closing duties, ensuring accurate stock levels and the orderly presentation of merchandise.
Housekeeper/Room Attendant
Courtyard Marriott
03.2018 - 08.2020
- Maintained high standards of cleanliness and sanitation by thoroughly wiping surfaces, cleaning floors, and making beds, ensuring a welcoming environment for guests
- Demonstrated a strong commitment to teamwork by providing timely assistance to colleagues, contributing to a collaborative and efficient work atmosphere
- Contributed to the overall guest experience by consistently displaying a friendly demeanor and addressing guest needs with prompt and courteous service.
Atrium Healthcare
11.2021 - 12.2022
- Maintained strict adherence to HIPAA regulations, ensuring patient confidentiality and privacy in all operations
- Collaborated with the Clinical Documentation Improvement (CDI) team to ensure concurrent coding accuracy and compliance
- Accurately abstracted and assigned ICD-9-CM and ICD-10-CM codes for the radiology department, supporting Medicare Risk Adjustment Model compliance.
Provider Services
Total Med/Centene Remote
10.2022 - 02.2023
- Accurately process policy or enrollment information to support brokers and agents, ensuring member details are correct and compliant
- Distribute ID cards and plan benefit details to Medicare and Medicaid members, facilitating their access to healthcare services
- Manage and update client and insured account information, including policy coverage, premiums, and partner contact details, for both active and cancelled accounts.
QA Analysts
Tranzact Remote
09.2023 - 02.2024
- Conducted comprehensive quality assurance testing for software applications at Tranzact, identifying and documenting defects, and collaborating with development teams to ensure the highest standards of software performance and reliability.
Education
Diploma - Nursing
West Mecklenburg High School
Diploma - Human Service and Behavioral Health Tech - Analyze healthier choices to manage your emotions and listening skills. Expected to understand and implement individual treatment plans and record patient behavior. Provide a safe, supportive environment for the patients. Technicians may provide and record patient medications and assisting in daily activities, whether therapeutic or recreational.
Purdue University Global
Certificate Medical Biller and Coder - Medical Billing and Coding
DeVry University
Skills
- Medical Billing
- Medical Coding
- Icd-9-Cm
- Icd-10-Cm
- HCPCS
- CPT
- Medical Terminology
- Electronic Health Records (EHR)
- Electronic Medical Records (EMR)
- Greenway
- Disease Processes
- Managed Care (HMO, PPO, and POS)
- Centers for Medicare and Medicaid
- CMS 1500
- CMS 1450 (Ub-04)
- Tricare
- EOBs
- Payment Posting
- Revenue Cycle Management
- Scheduling
- Meaningful Use
- Insurance Verification
- Insurance Billing Procedures
- Insurance Claim Processing
- Practice Management
- Medical Office Procedures
- Anatomy & Physiology
- HIPAA Compliance
- Co-Payments
- Deductibles
- Co-Insurance
- Super Bills
- Proficient in CPT and ICD-10-CM
- Analytical Skills
- Data Entry and Management
- Medicare Insurance Regulations
- Time Management
- Typing
- Medicare & Medicaid
- Medicare Supplement Policies
- Claims & IPA Claims
- Effective Communication
- Active Listening
- Problem-Solving
- Empathy
- Patience
- Customer Relationship Management (CRM)
- Quality Improvement
- Quality processes
Certification
- CPI Certification
- BLS Certification
- Medical Billing
- Medical Coder
- Certified Professional Coder
Timeline
QA Analysts
Tranzact Remote
09.2023 - 02.2024
Provider Services
Total Med/Centene Remote
10.2022 - 02.2023
Atrium Healthcare
11.2021 - 12.2022
Medical Coder
Humana Medical Insurance Remote
11.2020 - 04.2023
Housekeeper/Room Attendant
Courtyard Marriott
03.2018 - 08.2020
Cashier
Wendy's Monroe, NC
01.2017 - 03.2017
Cashier/Customer Service Representative
McAllister Deli Charlotte, NC
06.2015 - 08.2016
Production/Assembly
Alsco Charlotte, NC
05.2014 - 07.2015
Customer Service Representative
Humana/Concentrix
05.2014 - 07.2015
Diploma - Nursing
West Mecklenburg High School
Diploma - Human Service and Behavioral Health Tech - Analyze healthier choices to manage your emotions and listening skills. Expected to understand and implement individual treatment plans and record patient behavior. Provide a safe, supportive environment for the patients. Technicians may provide and record patient medications and assisting in daily activities, whether therapeutic or recreational.
Purdue University Global
Certificate Medical Biller and Coder - Medical Billing and Coding
DeVry University
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