Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Yasma Moncrief

Birmingham,Alabama

Summary

Dynamic professional seeking to leverage extensive skills and experience in a high-performance environment, emphasizing productivity and results. Proven track record of achieving targets and driving success through effective strategies and teamwork. Core competencies include project management, problem-solving, and strong communication skills. Committed to continuous improvement and professional growth within a results-driven organization.

Overview

27
27
years of professional experience

Work History

Healthcare Claims Examiner Team Lead

SS&C Formerly DST Systems
Birmingham, ALABAMA
04.2018 - Current
  • Provide day-to-day direction and guidance to approximately 7 to 15 Health Care Claims team members
  • Managed and supervised workflow.
  • Coordinated daily operations seamlessly.
  • Perform Quality Checks to ensure accuracy and to ensure deadlines are being met
  • Provide guidance on policy and procedure
  • Perform special project assignments from time to time, such as research work, obtaining special authorizations, conference/outbound calls and data entry
  • Cross train in different areas to expand knowledge base and develop new skill
  • Presented regular project progress reports during client calls.

Senior Healthcare Claims Specialist

DST Health Solutions
Birmingham, ALABAMA
02.2016 - 04.2018
  • Process complex hospital and medical claims in accordance with compliance policies and procedures
  • Resolve challenging issues from clients through thorough examination.
  • Review Client/Customer Service issues based on analytical research
  • Support new team members through onboarding process.
  • Resolve any other complex problems

Special Projects Representative

American Family Care Corporate
Hoover, ALABAMA
08.2014 - 02.2016
  • Conduct audit monitoring and document refund transactions from clinics.
  • Managed aging AR from Medicare, BCBS, Medicaid and various commercial insurance companies.
  • Compiled educational materials to streamline new hires' learning process.
  • Conducted thorough reviews of audit visits on hold.
  • Collaborated with BCBS Liaisons on claims billing issues.

Medical Billing Specialist

Rheumatology Assoc.
Birmingham, ALABAMA
08.2013 - 08.2014
  • Monitor Accounts Receivable Aging Report
  • Enroll patients with Copay Assistance Programs
  • Monitor daily Electronic Claims Report
  • Managed billing operations for all submitted medical claims.
  • Assessed and validated benefit qualifications.
  • Processed weekly payments from Medicare and BCBS AL.
  • Oversee accuracy and delivery of monthly financial documents for patients.
  • Pre-authorize scheduled infusions

Medicaid Team Lead

UAHSF
Birmingham, ALABAMA
09.2009 - 08.2013
  • Oversees functions of Third Party Representatives within the MSO.
  • Facilitated third-party representatives with electronic and manual billing.
  • Oversaw daily AR tasks handled by third-party representatives.
  • Examined complex invoices needing external help.
  • Conducted reviews of administrative claims and appeal submissions.
  • Review Charge Corrections and Coding issues with supporting documentation
  • Communicates with payers and management regarding payments and other billing issues
  • Organize monthly sessions to engage with staff.
  • Organize and oversee team discussions with senior executives.
  • Guided newly hired personnel in their roles as Third Party Reps.
  • Assessed quality assurance issues involving third-party reps.

Medicaid OB Special Billing Representative

UAHSF
Birmingham, ALABAMA
07.2005 - 09.2009
  • Conducted insurance follow-up on OB, radiology/oncology claims.
  • Medicaid Maternity Waiver Program billing
  • Audited work trails to minimize rejections.
  • Facilitated authorizations for a range of surgical interventions such as tubal ligations, hysterectomies, and abortions.
  • Coordinated setup of cases involving special billing and norplant insertions.

Medical Billing Representative

Birmingham Healthcare, Inc.
Birmingham, ALABAMA
04.2004 - 07.2005
  • Managed follow-up on self-pay, private insurance, and Medicaid accounts.
  • Handled claims for medical, dental, and vision insurance.
  • Processed payments from private insurance as well as self-pay sources.
  • Evaluated necessary adjustments for accurate resource allocation.

Customer Relations Associate

BCBS of Alabama
Riverchase, ALABAMA
10.2000 - 04.2004
  • Facilitated medical, dental, vision, and pharmacy benefits for various providers.
  • Tracked progress of processed claims.
  • Presented medical documents for evaluation.

Insurance Specialist

Brookwood Medical Center
Birmingham, ALABAMA
01.1998 - 10.2000
  • Managed the full cycle of billing for patient medical claims.
  • Confirmed benefits verification via Electronic Practice Management software with BlueCross BlueShield of Alabama.

Education

University of Ala - Elementary Education

University of Ala @ Birmingham
Birmingham, Al
01.1997

Community College - General Studies

Wallace Community College
Dothan, Al
01.1995

High School - General Studies

Enterprise High School
Enterprise, Al
01.1993

Skills

  • Microsoft Word Proficiency
  • Excel Proficiency
  • Computer Application Expertise
  • Google Chrome Expertise
  • Windows 10
  • ICD-9 Code Proficiency
  • Medical CPT Coding
  • Rockwell ACD Application Expertise
  • Impact
  • Proficient in 10-Key Operations
  • Multi-Line Call Management
  • Medical Terminology Expertise
  • Experience with IDX Systems
  • ETM
  • Health Quest
  • Relay Health
  • Centrix Software Expertise
  • Experience with Cerner
  • Familiarity with McKesson Systems
  • Practice Partners
  • MRO Process Optimization
  • PCS
  • CIS computer systems
  • Novell Groupwise
  • Microsoft Outlook Web
  • AS400 System Expertise
  • iCommunity
  • Docutap
  • ZirMed
  • Proficient in Exeter
  • PowerStepp Application Skills
  • Data Analysis with Pivot Tables
  • Amisys Application Skills
  • AWD Systems Knowledge
  • Experienced with Redbook
  • Dovetail Integration

References

Available upon request

Timeline

Healthcare Claims Examiner Team Lead

SS&C Formerly DST Systems
04.2018 - Current

Senior Healthcare Claims Specialist

DST Health Solutions
02.2016 - 04.2018

Special Projects Representative

American Family Care Corporate
08.2014 - 02.2016

Medical Billing Specialist

Rheumatology Assoc.
08.2013 - 08.2014

Medicaid Team Lead

UAHSF
09.2009 - 08.2013

Medicaid OB Special Billing Representative

UAHSF
07.2005 - 09.2009

Medical Billing Representative

Birmingham Healthcare, Inc.
04.2004 - 07.2005

Customer Relations Associate

BCBS of Alabama
10.2000 - 04.2004

Insurance Specialist

Brookwood Medical Center
01.1998 - 10.2000

University of Ala - Elementary Education

University of Ala @ Birmingham

Community College - General Studies

Wallace Community College

High School - General Studies

Enterprise High School
Yasma Moncrief