Shyisha Norman
Crowley,TX
Summary
Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims.
Overview
19
19
years of professional experience
Work History
Medical Claims Analyzer & Billing Trainer
Professional Medical Services
Fortworth,TX
10.2014 - Current
- 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.
- Responded to correspondence from insurance companies.
- Reviewed provider coding information to report services and verify correctness.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
Wokers Comp Claims QA Specialist
Bunch & Associates
Lakeland,FL
01.2006 - 01.2014
- Educated employees on specific QA standards and confirmed maintenance of standards.
- Monitored product standards and quality-control programs.
- Collaborated with management to provide training on improved processes and assisted with creation and maintenance of quality training.
- Inspected, verified and documented quantifiable characteristics of finished goods by comparing against customer specifications and company quality standards.
Insurance Billing Specialist
Rotech Healthcare
LAKELAND FL
01.2005 - 01.2006
- Identified, researched and resolved billing variances to maintain system accuracy and currency.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Generated and submitted invoices based upon established accounts receivable schedules and terms.
- Contacted clients with past due accounts to formulate payment plans and discuss restructuring options.
- Performed targeted collections on past due accounts aged over 60 days.
Customer Service Representative
MCI Phone Systems
Lakeland, FL
09.2003 - 01.2005
- Provided primary customer support to internal and external customers.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Collected and analyzed customer information to prepare product or service reports.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Processed customer adjustments to maintain financial accounts.
- Resolved challenging issues over phone with at least 50 customers daily.
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
Education
No Degree - Chemical Dependency Counseling
PCI Health Training Center
Dallas, TX08.2003
High School Diploma -
Lincoln Humanities/Communications Magnet High School
Dallas, TX05.2002
Skills
- Standard Classification Systems
- EPIC & STAR billing system knowledge
- Office Health Records Preparation
- Outpatient Coding
Timeline
Medical Claims Analyzer & Billing Trainer
Professional Medical Services
10.2014 - Current
Wokers Comp Claims QA Specialist
Bunch & Associates
01.2006 - 01.2014
Insurance Billing Specialist
Rotech Healthcare
01.2005 - 01.2006
Customer Service Representative
MCI Phone Systems
09.2003 - 01.2005
No Degree - Chemical Dependency Counseling
PCI Health Training Center
High School Diploma -
Lincoln Humanities/Communications Magnet High School
Similar Profiles
LaKeshia WilsonLaKeshia Wilson
IT Service Desk Manager at Professional Medical ServicesIT Service Desk Manager at Professional Medical Services
Tina HoveTina Hove
Claims Rep, Biller, Analyzer & Cash Posting at Professional Medical ServicesClaims Rep, Biller, Analyzer & Cash Posting at Professional Medical Services
Jessica JorgeJessica Jorge
Homecare Coordinator /Coordinator /Medical Billing Manager at Professional Medical Services, LLC.Homecare Coordinator /Coordinator /Medical Billing Manager at Professional Medical Services, LLC.