Latresa Dshone Jones

**** **** **** **** **** Phone: 706-***-****

Hephzibah, Georgia 30815 Email:

abixcn@r.postjobfree.com

Objective To obtain employment in a challenging yet rewarding position as

a data entry clerk, medical insurance specialist,

administrative assistant or similar position which allows

growth and development opportunities

Work Experience Medac, Inc Augusta, Georgia July 2007-Present

Insurance Specialist

. Process Claim Print Request/Refile Module

o Review the print request instructions on the

claim

o Compare the request with information currently

attached to the case in KAM using Contact

History notes, scanned, images, and billing

history

o Determine if print request is proper/HIPPA

complaint or necessary

o Carry out request instructions or notify CRM of

any improper requests/for review of request

o Sort claims into the appropriate account before

passing them out

. Secondary Claims Module and Daily Reconcile Paper

Secondary Claims

o Pull up case in KAM

o Review the information currently attached to

the case in KAM using Contact History Notes,

and billing history

o Determine if balance was transferred correctly

and if claim has a secondary balance

o Remove invalid secondary claims from the

module/alert CRM to transfer errors or attach

eob to paper claim and mail

. Reconcile Daily Paper

o Reconcile actual HFCAs (paper claim) against

the reconcile screen in the KAM 2000 Medical

Billing System

o Review each claim for issues and clearinghouse

capabilities

o Attach anesthesia notes to Workers Compensation

claims

o Sign Medicaid claims

o Medicaid Primary/Secondary Filing online for

accounts/carriers

Palmetto GBA Augusta, Georgia October 2002-

July 2007

QIC Assistant for Blue Cross Blue Shield in Columbus, SC

. Managed/filed appeals records

. Sorted and prepared all correspondence for scanning

. Performed scanning/imaging for all correspondence

received

. Performed data entry for all correspondence and

appeals documents received in QIC Document Control

. Logged, tracked and faxed effectuation information.

. Generated and mailed decision letters

. Faxed and mailed acknowledgement letters

OCR (Optical Character Recognition) Data Verifier

. Ensured that all proper areas of scanned images were

verified and corrected with timeliness and accuracy

. Entered claims into the processing system more

rapidly via the use of OCR

. Reduced the number of keying errors by being an

effective OCR Verifier

. Read CMS 1500 claims forms scanned into the system.

KQ Services, Inc. Augusta, Georgia

June 1999-September 2002

Management of Accounts Payable and Payroll Processing

. Researched, prepared, and composed memorandums and

letters for the company

. Completed verification of employment and

administrated background checks on potential

employees

. Prepared and ensured accurate completion of new hire

paperwork before submitting to supervisor for review

. Handled employee payroll sheets in addition to

keeping track of employee vacation and sick leave

. Answered multi-line telephone while remaining

courteous and professional

. Assisted in planning and organizing company functions

. Monitored accounts and billing processes, generated

invoices and credit memos

. Responsible for general ledger balances, computer

spreadsheets, and databases

. Analyzed contract accounts and established date

payments on delinquent accounts.

. Entered bills, invoices, and checks into the

QuickBooks database for payment

. Reviewed computer printouts against manually kept

ledgers and made corrections as needed

Skills Organization TDD Usage

Word Processing & Typing 10 Key Calculators

Filing Data Entry

Computer Proficiency: MS Word, Excel, Access, PowerPoint,

QuickBooks,

G-Neil Database

Education Augusta Technical College Augusta, GA 2003-2006

. Accounting Diploma, graduated September 2006

T.W. Josey High School Augusta, GA 1995-

1999

. College Prep Diploma with Vocational Seal, graduated

May 1999

References Furnished upon request

Contact this candidate