Karla M Harris

***** * ******* *** *** # ***

Tampa, Fl. 33612

813-***-****

abk7sz@r.postjobfree.com

Objective: To obtain a career in an office setting that will allow me to utilize my skills and training.

Qualifications:

• Detailed- oriented with strong communication skills.

• Capable of working independently and as team member.

• Strong work ethics, flexible, and committed to high quality work.

• Capable of handling multiple task and assignments.

• Highly motivated and professional and dedicated.

Education:

• Pentecostal Church Of God Christian Academy - 08/1988-06/2000

2540 Lucerne Park Road Winterhaven, Fl 33511

• Remington College-09/07/2006-04/01/2007- 6302 E Martin Luther King Suite 400

Tampa, Fl 33619

Studies-Into to Medical coding- CPT Coding for Medical office applications- Medical records management

Medical coding /ICD-9 codes- Coding for Hospital applications- Anatomy & Physiology for Mechanic Structures-Anatomy &

Physiology for Visceral Structures.

Employment:

• WellCare - 03/2009 - Present

Credentialing Assistant

• Prepare files for scanning.

• Assist with credentialing projects and or preparing external audit file reviews.

• Keeping a detailed log of termed files.

• Verifying the providers in the database in order to pull the file for scanning.

• Citrus HealthCare - 09/2007-08/2008

Credentialing Assistant

• Responsibilities include the intake and tracking of all applications.

• Review for completeness of information, indentify deficiencies.

• Confirm Hospital appointments and credentials standing.

• Accurately imputing data into Health Trio.

• Keeping a detailed log of all pending and national agencies.

• Enter and updating provider application data in credentialing database.

• Contact providers to verify accuracy of information, request data and follow up as needed.

• Conduct on-line credentialing verifications.

• Downloading of applications from CAQH.

• Citrus HealthCare- 03/2009- Present

Authorization Coordinator

• Review referrals request from PCP, check eligibility and benefits to determine if the referral is to the most effective

provider.

• Maintains telephone queue during office hours and assist callers.

• Assists PCP when a non-par provider may be needed.

• Communicates with the member and PCP to decrease ER utilization.

• Makes phone calls to members when ER follows up or education regarding ER use is identified.

• Faxes/mails referral/Pre-Cert decisions to PCP and or specialist provider.

• Maintains medical record files to comply with HIPPA requirements.

• Maintain a high level of confidentiality on all patient information.

• Allied Burton Security - 02/2007 - 05/2007

Patrol building, answering incoming calls, transferring calls to Management.

Light Book keeping

Data-Entry- input the daily report for the shift.

Weiser Security 07/2005 – 07/2006

Security Officer-greeting and directing all visitors and employees.

Speaking over a public address system.

Preparing and reviewing reports.

Filing Documents such as Police Reports and Badge Information.

Grand Hyatt

Assistant Supervisor/Expeditor) 11/2003 – 06/2005

Deliver food items to banquet staff.

Supervised staff of 10

Assist the supervisor with the invoices, paperwork and setup for the following day

Banquet Setup and Cleanup.

Einstein Bagels

11/2002 – 11/2003

Cashier/Food prep)

To perform friendly and enthusiastic service who can deliver excellent customer service.

Maintain preparing customer’s orders, making special drinks and sandwiches.

Skills

Interact with patients to clarify health insurance coverage and

financial responsibility

Use medical Management software to process health insurance claims, collecting co-payments and Posting Payments.

Correcting EOB’s and Denials

Calling and confirming appointments

Knowledge of different health insurance company’s

Daily I check in and out patients.

Knowledge of ICD-9 and CPT Coding

Windows XP

Medical Manager

Filing

Customer Service

Data Entry

Skills (Microsoft Word/Excel/Access) Email Applications.

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