Tabitha Harris
Hilliard,OH
Summary
Professional with extensive knowledge in the medical field. Strong organizational, analytical and customer service skills that can be brought into a billing, HR, or a payroll specialist position with an emphasis on customer service. Demonstrative Claims Auditor with background reviewing payment processes to deliver services, correct pricing and timely payments. Highly collaborative individual with over 16 years providing exceptional service via email and telephone to various individuals and organizations. Offering experience in different software applications and accounting procedures.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Claims Auditor
Cigna
01.2021 - Current
- Calculate the adjustments required to correct claims transactions
- Compile and produce audit reports that are detailed and unbiased
- Track audit activity and summarize results of claim analysis on a monthly basis for department statistics
- Educate providers on claim submissions, denials, appeals.
- Initiated cost containment by conducting thorough audits and data mining.
- Provided high level of professionalism when speaking with customers or responding to emails to promote company's dedication to service.
Tier 2 Customer Support
VSP Global
01.2018 - 12.2021
- Respond to customer inquiries ranging from routine to complex from members, clients, providers and internal/external business partners
- Responded to inquiries by phone, in person, or via chat, internet, and email
- Ensured accurate, timely and efficient customer support that supports VSP's global goals
- Maintain compliance requirements as per licensing and accrediting agencies
- Acting as an internal model for fellow employees
- Calculate adjustments required to correct claim transactions.
- Assisted customers in identifying issues and explained solutions to restore service and functionality.
- Used ticketing systems to manage and process support actions and requests.
Medical Billing/AR, AP, Payroll Specialist
Bright Star
01.2015 - 12.2018
- Practiced timely and accurate preparation of all payroll operations working closely with human resources and ADP for weekly pay of over 200 employees
- Post and reconciled all Insurance and patient Payments
- Set up practice management software for submission of electronic claims to clearinghouse
- Sent secondary claims upon processing from primary insurance
- Review aging reports and find solution to correct collections and increase cash flow
- Medicaid, Aetna, Molina, Passport, DODD, Senior Options, MITS Waiver, Senior Bridge.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility.
Surgery Scheduling and Credentialing Specialist/CMA
Complete Healthcare for Women
01.2012 - 12.2015
- Scheduled 3 Physicians at 6 locations
- Pre auths, Insurance verification
- Credentialed 2 Dr's, Maintained credentialing for 3 Dr's
- Assisted in Surgery as a CMA at least 2 days per week, triage, Answered Billing Questions for Staff and Patients when outsourced.
- Conducted primary source verifications such as background checks and board certifications.
- Prepared records for site visits and file audits.
Director of Marketing and Development/Medical Billing/CMA
Vectra Home Care
01.2010 - 12.2011
- Posted charges/EOB's/Entered Demographics, Insurance Info./485's
- Managed Social Media, Built relationships to obtain patients
- New Patient intake, scheduling, vitals, electronic charting, testing.
- Managed annual marketing budget in excess of $100,000.
- Devised marketing plans using digital strategies, print advertising, and word of mouth tactics.
Education
No Degree - Medical
Bryman Institute
Gahanna, OH01.2005
High School Diploma -
Thompson High School
Scranton, PA01.2000
Skills
- Payment Analysis
- Benefits Guidelines
- Accounting Practices
- Compliance and Regulations
- Experienced in Microsoft 10, Excel Powerpoint
- Exemplary Communication Skills
- Claims Auditing
- Data Analytics
- Process improvement
- Quality assurance
- Customer service
- Documentation review
Certification
- AED Certification
- First Aid Certification
- Certified Medical Assistant
- CPR Certification
Timeline
Claims Auditor
Cigna
01.2021 - Current
Tier 2 Customer Support
VSP Global
01.2018 - 12.2021
Medical Billing/AR, AP, Payroll Specialist
Bright Star
01.2015 - 12.2018
Surgery Scheduling and Credentialing Specialist/CMA
Complete Healthcare for Women
01.2012 - 12.2015
Director of Marketing and Development/Medical Billing/CMA
Vectra Home Care
01.2010 - 12.2011
No Degree - Medical
Bryman Institute
High School Diploma -
Thompson High School
Similar Profiles
Rudee FriarRudee Friar
Customer Service Representative at CignaCustomer Service Representative at Cigna
Tiffany LovatoTiffany Lovato
Customer Service Advocate at CignaCustomer Service Advocate at Cigna
Luis GilLuis Gil
Customer Service Representative at CignaCustomer Service Representative at Cigna
TIA WHITETIA WHITE
Senior Enrollment / Medical Billing Specialist at CignaSenior Enrollment / Medical Billing Specialist at Cigna
Faisa HersiFaisa Hersi
Lab Supervisor at OhioHealth Doctors HospitalLab Supervisor at OhioHealth Doctors Hospital