Tahira R. Brame

215-***-****

Healthcare administrative professional seeking an entry level position within an organization where I have the ability to expand my claims/billing and A/R follow-up skills

02/2013 – Present

Amerihealth Caritas Family of Companies

Claims Examiner

Handle all claims for members and providers in an efficient and professional manner. Analyze and understand the coverage provided under a member's plan. Utilize multiple systems to obtain and record claim information, data entry and to make claim payment decisions. Responsible for the timely handling, accurate processing, documentation of all incoming claims and perform other duties as assigned. Maintain production and quality standards, with the ability to seek innovative ways to improve service. Currently trained on the following lines of business – Pennsylvania – LOB 100/500; D.C. – LOB 3700; Louisiana - LOB 2100 and currently training on Florida – LOB 6400

1/2010 – 02/2013

Apollo Health Street

Claims Coordinator

Frontend claims team

Reviews all claim edits assign to a daily queue to determine proper payment adjudication. Reviews all services for accuracy of charges edits. Determines payments and denials based on provider contract or lack thereof.

Pend claims requiring additional information special handling; updating all actions in system. Forwards claims requiring additional review to the appropriate department or person.

Monitors outstanding inquiries to ensure that they are completed in a timely manner.

Reviews and verifies audit reports. Complete all audit discrepancies and make necessary changes to avoid additional occurrences of errors received.

Meet and maintain all daily production and monthly quality standards.

Responds to all written and verbal queries including emails, phone calls from our client.

8/2009 – 12/2009

Unique Staffing

Billing representative

Assigned to hospital billing departments and physicians’ offices to handle clerical duties. Theses duties include entering patient demographic information and all procedures performed into assigned billing systems.

3/2007-8/2009

Hospital of the University of Pennsylvania

Presbyterian Hospital

Medical Records representative

Responsibilities were to complete requests for medical records from all areas of Hospital and outside entities – including testing and monitoring facilities; family requests for records; Municipal and court request and emergency request for physicians within the hospital.

Education:

Benjamin Franklin High School

References furnished upon request