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, Al01.1997
Community College - General Studies
Wallace Community College
Dothan, Al01.1995
High School - General Studies
Enterprise High School
Enterprise, Al01.1993
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
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