Organized with foundation in records management. Experienced in billing and collection procedures. Advanced medical terminology knowledge.
Approachable Strong interpersonal skills MS Office Program evaluation
Experienced Project Manager
Process improvement techniques
Adaptable Microsoft Word, Excel, Outlook,PowerPoint, and Internet Explorer 2003-10
Organized with foundation in records management,
Experienced in billing and collection procedures, Advanced medical terminology knowledge.
Enrollment Representative II08/2015 to CurrentQualChoice Health InsuranceLittle Rock, AR
Presented and clearly explained insurance policy options to clients based on their needs and goals.
Promoted client retention through high-quality service and follow through.
Accurately process high volumes of eligibility timely.
Verify completeness of each new enrollment application by reviewing the application along with the group setup for waiting periods and benefit plans to insure accuracy.
Verify and accurately enter each new enrollment application into the eligibility system within 24 hours of receipt.
Accurately update eligibility changes within 2 days of receipt.
Effectively communicate via phone or in writing with enrollees, group contacts brokers.
Efficiently answer call concerning the online application and reset passwords.
Check enrollment queues and process routes on a daily basis.
Generate and process weekly discrepancy reports.
Process return mail on a daily basis.
Scan and index eligibility correspondence into the imaging system.
Accurately process excel reporting for the State Health insurance.
Administrative Analyst/TANF Monitoring02/2014 to 07/2015ARKANSAS DEPARTMENT OF WORKFORCELittle Rock, AR
Gathered and analyzed data for studies and reports and made recommendations based on findings.
Cultivated close working relationships with other municipalities and governmental agencies to achieve the success of TANF programs in accordance with the State and Federal Law.
Monitored funding for ongoing community programs for TANF (Temporary Assistant for Needy Families).Collaborated with members of the state and other public agencies and private organizations to achieve the specific guidelines of the Request for Qualification (RFQ) and Memorandum of Agreement (MOA).
Act as a liaison for ADWS with the public sector to provide guidance and resolve problems or issues pertaining to the services provided to participant's eligible for the TANF (Temporary Assistant for Needy Families) program.
Manages the auditing of assigned program expenditures to ensure expenditures are within established guidelines and are in accordance with appropriate cost category; ensure expenditures did not exceed allocated budget; manages budget accounts to ensure adequate funds are available.
Investigates administrative and operational problems and complaints; reports findings and recommend solutions.
Answers questions and provides information to contractors and other state employees regarding the
Financial Service Specialist04/2006 to 09/2012MEDICARE PINNACLE BUSINESSNorth Little Rock, AR
Researched questions and concerns from providers and provided detailed responses.
Maintained strict patient and physician confidentiality.
Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
Managed collections claims for unpaid bills against the estates of debtors.
Interacted with providers and other medical professionals regarding billing and documentation policies, procedures and regulations.
Accurately posted and sent out all medical claims.
Processed denied claims for timely filing.
Precisely evaluated and verified benefits and eligibility.
Responded to correspondence from insurance companies.
Posted and adjusted payments from insurance companies.
Identified and resolved patient billing and payment issues.
Printed and reviewed monthly patient aging report and solicited overpayments.
Confidently and adeptly handled claim denials and/or appeals.
Facilitated the processing of Medicare Secondary Payer (MSP) and IN/Outpatient hospital claims.
Investigated and solved cases for Medicare involving Veteran Administration, Workman's Compensation, Black Lung, ESRD, No-Fault Insurance, Aged Workers, and Disability Beneficiaries.
Reviewed collection reports to determine the status of collections and the amounts of outstanding balances.
Initiated cash receipts.
Processed accounts receivables.
Effectively managed a high-volume of inbound and outbound customer calls.
Gathered and verified all required customer information for tracking purposes.
BACHELOR OF SCIENCE
Public Adminstration2003University of Central ArkansasConway, AR, US
accounts receivables, administrative, auditing, billing, budget, cash receipts, interpersonal, CPT, ESRD, funds, ICD-9, Insurance, Internet Explorer, Law, Excel, Outlook, Powerpoint, Microsoft Word, coding, protocols