Natoshia Mitchell

Marietta, Georgia

770-***-****

acumbb@r.postjobfree.com

SUMMARY

Over 12 years of experience analyzing and monitoring electronic data interchange (EDI) files, maintaining databases to track business performance, and updating, reprocessing claims and call center experience. Analyze data and summarize performance using summary statistical procedures. Strong organizational, planning and follow up skills. Ability to motivate and lead others.

Core areas of expertise include:

Microsoft Office Suite

Data processing and analysis skills

ICD-9, CPT-4 and HCPCS coding systems

Medical contract analysis and evaluation

Experience with XML, ePremis, Allscript, Athena

Extensive experience with EDI systems

EXPERIENCE

Charge Entry Specialist

Avery Partners Healthcare 01/2016-Present

Key Responsibilities

Schedule and register patients in Client’s EMR system with production driven and quota base

Update patient demographics and insurance information

Verify insurance eligibility and coordinate benefits (i.e. primary, secondary, supplement, replacement plans, etc.)

Analyze patient packs and post charges

Experience with leading and developing teams (i.e. Providence team and Large accounts team)

Convert ICD-9/10 codes and append modifiers

Create and submit claims for medical billing

Post time of service payments and reconcile batches

Identify, track and report fee schedule and coding issues

Specialty clinics include; Acute Care, Electrophysiologist, GYN Oncology, Breast Health, Cardiothoracic and Vascular, Digestive Disorders, ENT, GI, Intensivists, Hospital Professional Services, Interventional Pain Management, Neurology, OBGYN, Orthopedic, Psychiatry, Radiology, Surgical, Spine and Wound Care.

Managed Care Data Specialist

Apollo MD/Payments-MD, Atlanta, GA 5/2011 – 9/2014

Key Responsibilities:

Assist with month-end closing and future revenue outlook and quarterly forecasting.

Analyze patient packs and post charges

Provide complete, thoughtful, and compelling evaluative information through peer collaboration and independent research, compilation, and analysis of data.

Evaluate health care administrative data in order to identify insurance cost, quality, and utilization trends.

Analyze contracts to ensure reimbursements are within established guidelines.

Exhibited working knowledge of EDI 837, 277U, 276/277, 997, 835,820 submission, ERA, EFT in the medical environment.

Create and submit claims for medical billing

Post time of service payments and reconcile batches

Natoshia Mitchell Page 2 of 2

Systems Coordinator (EDI)

Medical Management Professionals, Kennesaw, GA 5/2010 – 4/2011

Key Responsibilities:

Managed workflow process for electronic transactions representing nearly $100M in annual revenue.

Investigate, resolve and communicate provider claim issues and charges.

Assist with Month end closing and future revenue outlook and quarterly forecasting.

Accessed reports, maintained records, researched, identified, and corrected report errors.

Worked closely with providers and office managers to engineer and re-engineer processes for efficiency and to ensure no lost charges.

Provided comprehensive support for electronic claim submissions and Electronic Data Interchange (EDI) needs.

Network Connectivity Analyst (EDI)

Wellcare Health Plans, Tampa, FL 6/2004 –5/2009

Key Responsibilities:

Receive and effectively respond to providers issues

Provided comprehensive support for electronic claim submissions and Electronic Data Interchange (EDI) needs.

Investigate, resolve and communicate provider claim issues and charges.

Performed duties to act as a liaison between providers, the health plan and Corporate.

Exhibited working knowledge of EDI 837, 277U, 276/277, 997, 835,820 submissions, ERA, EFT in the medical environment.

Identify, track and report fee schedule and coding issues

Experience with leading and developing teams (i.e. denial team and outbound calls team)

Perform training and coaching performance improvement within the network and assist with claim resolution.

EDUCATION

Strayer University, Atlanta, GA. Master of Business Administration with a minor in Health Administration, June 2014

Phoenix of University, Marietta, GA. Bachelor of Business Management, April 2011

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