Tamika Malcolm
Coram
Summary
Seeking to utilize excellent communication, interpersonal, and organizational skills to complete tasks. Reliable with a good work ethic and the ability to quickly adapt to new tasks and environments.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Medical Billing Analyst
Millin Associates
Lynbrook, NY
03.2022 - 03.2023
- Prepares and submits clean claims to various insurance companies either electronically or by paper. Verifies eligibility for patients claims. Manually enters data into MillinPro+. Works directly with insurance company and healthcare provider to get the claims paid. Posts remits electronically and manually from Emdeon, Payspan or eBridges or any additional website/portal/clearinghouse. Maintains and addresses follow up items on client issue trackers. Creates and maintains a weekly report on billing for clients. Performs claims follow up tasks including online research as well as phone calls to payers to resolve billing issues.
Medical Billing Specialist
Long Island Hematology and Oncology
Syosset, NY
09.2018 - 01.2022
- Maintained up-to-date records of payments received from insurance companies, patients, and other sources. Utilized electronic billing systems to submit claims to insurance providers in a timely manner. Researched denied or rejected claims for accuracy and took appropriate action to resolve discrepancies. Daily charge entry. Payment posting reconciliation. Conversated with doctors daily. Set up peer reviews between provider and insurance carrier. Answered all patient or insurance telephone inquiries pertaining to assigned accounts. Analyzed patient records and accurately coded diagnoses and procedures according to ICD-10 guidelines. Collaborated with healthcare providers and office staff on billing issues as necessary.
Claims Examiner (Telecommute)
HealthFirst
New York, NY
07.2012 - 06.2018
- Processed and adjudicated claims based on timeliness and policies and procedures. Examined claims to ensure appropriate fee schedule is being used for accurate code reimbursement. Reviewed and investigated claims and encounters for medical, facility, pharmacy, dental and vision services including contractual provisions, authorizations and Healthfirst Policy and Procedure. Subsequently audited and handled specific claims and appeal requests including processing where applicable, tracking, documenting, reporting and dispersal of findings, root cause analysis and recommendations. Reported and presented preliminary findings based on trending and interpretation. Performed APG Claims Pricing through 3M. Conducted NDC code pricing through Reimbursement Vendor website. Coordinated required information between Management staff and team members to complete daily assignments. Lead team in working on multiple audits, appeals & grievances as well as special projects.
Education
Diploma - undefined
Half Hollow Hills High School
Dix HillsHealthcare Studies - Healthcare
Suffolk County Community College
Selden, NY05.2027
Skills
- Front desk, Medical terminology, Verbal and written communication, Analytical problem solving, Payment Processing, Claims Processing, Customer service, Communication skills, Computer literacy
Certification
Medical Billing Certification
Timeline
Medical Billing Analyst
Millin Associates
03.2022 - 03.2023
Medical Billing Specialist
Long Island Hematology and Oncology
09.2018 - 01.2022
Claims Examiner (Telecommute)
HealthFirst
07.2012 - 06.2018
Diploma - undefined
Half Hollow Hills High School
Healthcare Studies - Healthcare
Suffolk County Community College