Trecia Holloway
Columbia,SC
Summary
Aspiring Master of Human Resource Candidate with experience in customer and client satisfaction with a robust background in medical claims analysis and resolution. Adept at streamlining claim processing workflows and ensuring adherence to industry regulations. Valued team player with focus on collaboration and achieving optimal results, exhibiting flexibility to adapt to evolving demands. Proficient in medical coding, data analysis, and regulatory compliance, showcasing reliability and results-driven mindset.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Claims Processor II
CGS Administrators
10.2022 - Current
- Resolve system edits, audits, and claims errors through research and use of approved references and investigative sources
- Coordinate with internal departments to work edits and deferrals
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Managed workload and priorities to meet claims processing meet deadlines.
- Collaborated with cross-functional teams to resolve complex claims issues efficiently and effectively.
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Reduced errors in claims submissions through meticulous attention to detail and thorough review processes.
- Improved claim processing efficiency by streamlining workflows and implementing best practices.
- Skillfully navigated Medicare/Medicaid regulations in order to secure maximum reimbursement rates for qualifying services provided.
- Managed high volume of claims, consistently meeting deadlines without compromising accuracy or quality.
- Conducted regular audits of processed claims to identify areas for improvement and potential fraud risks.
- Utilized advanced knowledge of ICD-10 codes to accurately process complex medical claims.
- Assisted in the development of policies and procedures related to medical claims management, ensuring compliance with industry regulations.
Server
Kpot
06.2023 - 08.2023
- Demonstrated strong multitasking skills by managing multiple tables simultaneously without compromising service quality.
- Served food and beverages promptly with focused attention to customer needs.
- Worked with POS system to place orders, manage bills, and handle complimentary items.
- Collaborated with team members during busy shifts for efficient workflow and excellent guest experiences.
- Cultivated warm relationships with regular customers.
Server/Bartender
Winchester - All In Hospitality Group
04.2022 - 10.2022
- Demonstrated strong multitasking skills by managing multiple tables simultaneously without compromising service quality.
- Served food and beverages promptly with focused attention to customer needs.
- Worked with POS system to place orders, manage bills, and handle complimentary items.
- Collaborated with team members during busy shifts for efficient workflow and excellent guest experiences.
- Enhanced customer satisfaction by promptly attending to their needs and providing personalized service.
Patient Access Specialist
Medassist, A Firstsource Company
02.2020 - 04.2022
- Medicaid patient screening for enrollment, completing applications on patient behalves, Adding dependents, updating coverage, adding additional insurance coverage, terminations, adding newborns and, interpreting applications per SC state guidelines
Business Office Associate
Lexington Medical Center
09.2019 - 01.2020
- Verify insurance coverage, process, track referrals, and prior authorizations
- Explain financial requirements to patients, update patient records, medical records specialist
- Assist Physicians with day to day appointment flow
Medical Claims Specialist II
VBOA
10.2017 - 09.2019
- Account handling, account resolution, money resolution, insurance verification, insurance billing, cash goals, communication with team, maintaining metrics which include attendance, productivity, and quality
Patient Care Technician
Palmetto Health
01.2015 - 09.2017
- Assist patients with ADL’s, direct patient care, charting, admissions and discharges, customer service, inbound calls, grieve support for families, assist nurse and doctors in Code Blues (Adult medical emergency).
CNA - Certified Nursing Assistant
White Oak Management, Inc.
09.2013 - 10.2016
- Ad's, patient care, charting, admissions and discharges, customer service, inbound calls, handle grieving families, assist nurse and doctors with tasks
Education
Bachelor of Science - Psychology
Colorado Technical University
Colorado Springs, CO10.2022
Trade school -
ABC school of bartending
Charlotte, NC03.2022
High School Diploma -
Saluda High School
Saluda, SC05.2010
Skills
- Document Management
- Data Entry
- Applicant screening
- Decision-Making
- Microsoft Office
- Analytical and Critical Thinking
- FISS
- PowerPoint
- Excel
- Word
Certification
- AED Certification
- Bartender License
- Cosmetology License
Personal Information
Work Permit: Authorized to work in the US for any employer
Awards
- 2018, Highest overall metrics
- 2023, Discovered a system issue that was incorrectly rejecting all claims due to a system error preventing my team from missing monthly metrics.
- 2023, Claims coach
Assessments
- Work style: Reliability, Proficient, 04/01/22
- Call center customer service, Proficient, 05/01/21
Timeline
Server
Kpot
06.2023 - 08.2023
Claims Processor II
CGS Administrators
10.2022 - Current
Server/Bartender
Winchester - All In Hospitality Group
04.2022 - 10.2022
Patient Access Specialist
Medassist, A Firstsource Company
02.2020 - 04.2022
Business Office Associate
Lexington Medical Center
09.2019 - 01.2020
Medical Claims Specialist II
VBOA
10.2017 - 09.2019
Patient Care Technician
Palmetto Health
01.2015 - 09.2017
CNA - Certified Nursing Assistant
White Oak Management, Inc.
09.2013 - 10.2016
Trade school -
ABC school of bartending
- AED Certification
- Bartender License
- Cosmetology License
Bachelor of Science - Psychology
Colorado Technical University
High School Diploma -
Saluda High School
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