SHEENA ANDERSON
Tampa,FL
Summary
Dedicated healthcare professional with over 10 years of experience in customer service and claims handling. Skilled in researching and analyzing claims processing systems, provide information to provider about claims, assist members with benefits coverage and premium payments and ensuring compliance with CMS guidelines. Seeking to leverage expertise in
Qualified Claims Representative versed in investigating claims, verifying information and managing settlements. Friendly and upbeat team player with organized and disciplined approach. Offering 10 years of insurance experience.
Overview
19
19
years of professional experience
Work History
Phlebotomist/Administrative Assistant
Dynamic Health
01.2020 - 01.2024
- Maintains a complete understanding of all patient data entry requirements in accordance with policy and procedure
- Understands and practices Patient Safety Goals as outlined annually by Joint Commission
- Knowledgeable in all phlebotomy techniques to include micro puncture, venipuncture, blood bank collection process, blood culture collection process, and bleeding time
- Familiarity with the laboratory reception, front desk area and able to cover as required
- Explain all processes to assist in minimizing customer/patient anxiety
- Answer patient questions when appropriate and within their scope of practice
- Prints Pending Logs, reviews, and follows through with uncollected specimens
- Works as a team member to assist others in the lab in completing assignments
- Participates in inter or intra departmental performance improvements
- Provides administrative support to physicians, advanced practitioners, medical directors and/or practice managers
- General office duties, including but not limited, to copying, filing, faxing, check requests, mailings, typing of correspondence, initiating, and responding to emails, conference call scheduling, creating, and maintaining spreadsheets, creating, and maintaining files
- Answer the phones as needed and transfers calls to designated staff
- Utilize Microsoft Office programs (Excel, Word, PowerPoint) to create and maintain correspondence, spreadsheets, presentations, etc
- Maintenance/management of all office equipment to include phone, voicemail, and computer systems
- Orders, maintains, and ensures availability of supplies and materials for the department within the budgetary parameters
- Arrange and coordinate travel arrangements for the medical staff as needed
- Organize and track credentialing needs for physicians and advanced practitioners
- Records meeting minutes, as needed
- Schedules meetings and maintains calendars for the physicians and advanced practitioners as needed
- Maintain strict confidentiality in accordance with HIPAA regulations and Company policy
- Responsible for following all facility, organization and department precautions and procedures in the performance of all job duties to ensure a safe work environment for self and others
- Complete compliance requirements as needed
- Perform other duties as assigned or requested
Medical Biller
Advance Billing and Collection Solutions
01.2012 - 01.2024
- Reviewed claims for further follow-up and resolution
- Performed initial, corrected, and secondary claim submission through multiple billing software programs and clearinghouses
- Performed follow-up procedures on outstanding claims
- Performed medical documentation retrievals, reviews, compilations, and submissions
- Performed audit responses to pre- and post-payment audits
- Completed payment posting including contractual obligations, write-offs and refunds
Info/Referral Specialist
Marine Corps Community Service
01.2016 - 01.2017
- Acted as a central point of contact for service members and their families by connecting them to necessary resources and services available both on base and within the local community; by assessing their needs and directing them to the most appropriate support organizations or programs
- Conducted initial interviews with service members and their families to identify specific needs related to housing, finances, healthcare, childcare, legal assistance, mental health, and more
- Maintained an updated directory of available services on and off base, including contact information, eligibility requirements, and service details
- Directed individuals to the appropriate service providers based on their assessed needs, including scheduling appointments or providing necessary paperwork
- Provided comprehensive information about available programs and benefits to service members and their families through various channels like briefings, website updates, and individual consultations
- Collaborated with local community agencies to build partnerships and ensure seamless access to external services
- Tracked referrals and follow-up to ensure individuals are receiving the necessary support and addressing any concerns
- Adhered to strict privacy policies when handling sensitive personal information
Customer Support Representative
My Matrixx
01.2011 - 01.2012
- Answered questions from customers regarding the My Matrixx Pharmaceutical products and its extended services in a friendly, effective, and efficient manner
- Diagnosed and resolved basic and complex customer questions or problems over the telephone or through electronic communication in the areas of system configuration/setup, product functionality, and bugs/enhancements
- Interacted with customers to troubleshoot and resolve customer issues that may not have standard documented solutions
- Ability to document new issues, FAQs, and resolutions for a robust knowledge base
- Identified critical issues that may impact all clients, provided proactive communications, product fixes and subsequent uploads
- Tracked and documented inbound support requests and ensured proper notation of customer problems and issues
- Worked closely with customers to ensure we are providing solutions that meet their needs
- Stayed abreast of current technology in products, design changes, and new products offered
- Complied with all federal and state laws, rules and regulations governing the practice of pharmacy and the delivery of medical equipment and supplies
CSR/Deduction Specialist
Innovative Concept Group Food Service
01.2005 - 01.2011
- Processed and cleared valid deductions, disputed all invalid deductions, and collected all disputed amounts
- Researched and resolved customer deductions including overages, reclamations, damages, freight, fines, product returns and other non-promotional deductions
- Researched on customer portals, agreements, or payment advice, identified invalid customer deductions, and developed a specific plan to recoup any amounts owed and avoid future invalid deductions
- Effectively organized, saved, and attached supporting documentation to help report and validate deductions
- Collaborated with other departments to provide insight on process gaps and opportunities
- Identified deduction trends at the customer level and communicated such trends and helped develop recommendations for the team to review and implement
- Supported strategic customers, pricing management, reporting, and analysis
- Completed any special projects as assigned
Education
Associate of Arts - Business
AMERICAN PUBLIC UNIVERSITY
05-2024
Certified Phlebotomy Technician - Nation Certified
CLINICAL TRAINING INC.
TAMPA, FL01.2022
CPC Certified Professional Coder -
AAPC
ONLINE01.2012
Emergency Medical Technician - undefined
HILLSBOROUGH COMMUNITY COLLEGE
TAMPA, FL01.2007
Skills
- Venipuncture Techniques
- Blood Collection Equipment Handling
- Specimen Processing and Labeling
- Communication Skills
- Patient Interaction
- Customer Service
- Team Collaboration
- Effective Verbal Communication
- Effective Written Communication
- Organizational Skills
- Time Management
- Record-Keeping and Documentation
- Attention to Detail
- Problem-Solving
- Critical Thinking Skills
- Identifying and Resolving Collection Issues
- Adapting to Challenging Situations
- Professionalism and Ethical Behavior
- Maintaining Patient Confidentiality
- Adhering to Safety and Infection Control Standards
- Compliance with Regulatory Requirements
- Elation Health EHR
- Tebra Medical Practice Management EHR
- Practice Fusion EHR Software
- Kareo Healthcare EHR
- DME
- Pharmacy Billing
- Pharmacy Workflows
- Patient Registration
- Order Entry
- Clinical Monitoring
- Dispensing
- Compounding
- NCPDP Adjudication
- Inventory Management
- Microsoft Office Suite
- Excel
- Word
- PowerPoint
- Outlook
- Reporting
- Copying
- Filing
- Faxing
- Check Requests
- Mailings
- Resource Database Management
- Correspondence
- Emails
- Conference Call Scheduling
- Travel
- Creating/Maintaining Spreadsheets
- Knowledge of Military Benefits/Policies
- Referral Coordination
- Information Dissemination
- Community Outreach
- Case Management
- Confidentiality Maintenance
- Creating/Maintaining Files
- Patient confidentiality
- Medical records handling
- Patient assessment
- EMR recordkeeping
- HIPAA
- Medical records review
- Medical records management
- Medical records maintenance
- Data entry
Timeline
Phlebotomist/Administrative Assistant
Dynamic Health
01.2020 - 01.2024
Info/Referral Specialist
Marine Corps Community Service
01.2016 - 01.2017
Medical Biller
Advance Billing and Collection Solutions
01.2012 - 01.2024
Customer Support Representative
My Matrixx
01.2011 - 01.2012
CSR/Deduction Specialist
Innovative Concept Group Food Service
01.2005 - 01.2011
Certified Phlebotomy Technician - Nation Certified
CLINICAL TRAINING INC.
Emergency Medical Technician - undefined
HILLSBOROUGH COMMUNITY COLLEGE
Associate of Arts - Business
AMERICAN PUBLIC UNIVERSITY
CPC Certified Professional Coder -
AAPC
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